Lingual abscess: a case report

Abstract

BackgroundLingual abscesses have become extremely rare since the discovery of antibiotics, despite the relatively frequent exposure of tongue to bite trauma during mastication and seizures. It is a potentially life-threatening clinical entity. Even though there were some case reports on tongue abscess from overseas, none of them were reported from Africa, particularly from Ethiopia.Case presentationA 36-year-old male patient with severe, continuous pain and swelling of tongue for 6 weeks was presented to Goba Referral Hospital. The swelling was 2 cm by 1 cm, located on posterior central tongue, and frank pus oozed from the center of the swelling. He had associated dysphagia, odynophagia, and speech difficulty. He had no previous personal and family history of similar illness and tonsillitis. Gram staining revealed the presence of Gram-positive cocci in clusters. Pyogenic lingual abscess was the diagnosis. Treatment included incision and drainage with the administration of systemic antibiotics, which covered both aerobic and anaerobic organisms, and anti-pain drugs. The condition did not relapse in 6 months of follow-up.ConclusionLingual abscess should be considered in patients presenting with tongue swelling, dysphagia, odynophagia, and speech difficulty. Since lingual abscess that occurs on the posterior part of the tongue has diagnostic difficulty, professionals in rural setup where diagnostic resources (such as ultrasound and magnetic resonance imaging) are scarce should be careful not to misdiagnose it. Incision and drainage with the administration of systemic antibiotics and anti-pain drugs is an effective treatment option for lingual abscess.

Recurrent Lingual Abscess in an Elderly Female With Bulbar Amyotrophic Lateral Sclerosis

“…For anterior lingual abscesses, predisposing factors include heavy smoking, local trauma, poor dental and salivary health, and, most commonly, impaction of foreign body (fishbone, toothbrush bristles, toothpick, etc.) [1][2][3]7]. For posterior lingual abscesses, the dominating factors are lingual tonsillitis and infected thyroglossal duct cyst [2,3,7].…”

Clinical and Diagnostic Aspect of Tongue Abscess

“…Lingual abscess is a rare potentially life-threatening clinical entity, often considered an emergency. 3 Despite exposure to many potential pathogens, tongue is comparatively immune to infection and an unusual site of abscess. Some of the reasons for this immunity include constant mobility of the tongue, which helps the saliva produce a perpetual cleansing effect; its thick covering of keratinized mucosa, which is not easily penetrated by microorganisms; the muscle tissue, which constitutes the chief bulk of its parenchyma, with its rich vascular supply; its rich lymphatic drainage; and the immunologic properties of saliva.…”

“…1,2 It is a potentially life-threatening clinical entity because elevation and backward displacement of tongue may compromise airway. 3,4 Accurate diagnosis of these lesions has important prognostic and therapeutic implications. 1 When diagnosed, these lesions are opened and drained.…”

Macroglossie Spontanee Aigue : Quel Est Votre Diagnostic?

“…L'association la plus recommandée dans la littérature est la céphalosporine 3éme génération, métronidazole pour une durée de 15 jours. [9,10] Dans la littérature certains auteurs optent pour la ponction évacuatrice à vif pour les abcès de la langue mobile, tandis que le drainage chirurgical est recommandé dans les collections siégeantau niveau de la base de langue. [1,4,5] Notre patiente a bénéficié d'un drainage après avoir assuré la libérationdes voies aériennes.…”