Acute tongue abscess: report of two cases

Lingual Abscess: Predisposing Factors, Pathophysiology, Clinical Manifestations, Diagnosis, and Management

Lingual abscess is a rare disorder, and current knowledge regarding clinical manifestations and treatment modalities has not been well established. This study presented 6 cases of lingual abscess patients between January 2012 and December 2017. There were three men and three women. Median age was 54 years. Odynophagia and local pain were the common presenting symptoms. Local trauma was the main predisposing factor of anterior abscess, while lingual tonsillitis or infected thyroglossal cyst was the predisposing factor of posterior abscess. An impending airway obstruction was identified in two patients, requiring tracheostomy. All patients achieved an excellent outcome with a combination of surgical drainage and proper antibiotics as well as using proper investigation for detecting unusual areas of lingual abscess. According to the data from the study's results and review of the relevant literature, an abscess located at the anterior two-thirds of the tongue is easy to diagnose while the posterior one-third of the tongue abscess is relative difficulty. Using contrast-enhanced computed tomography increases diagnostic accuracy, especially on the tongue base and deep space infection. The management strategies include (1) protecting the airway, (2) draining the abscess by needle aspiration or surgery, and (3) administering antibiotics early. Our series showed a superiority of surgical drainage when the patients present with marked tissue edema, deep loculated infection, and airway obstruction.

Tongue abscess: a rare clinical entity

Swelling of the tongue is a rare clinical entity. It is a potentially life-threatening condition, as it could result in airway compromise. The differential diagnosis of acute tongue swelling includes hemorrhage, infarction, abscess, tumor, and edema. A tongue abscess should be considered in all cases of acute tongue swelling, especially when host defenses are severely impaired. Although the diagnosis of lingual abscess can be reached clinically because of the rarity of the condition, in neglected cases, the diagnosis can be difficult. Despite of the rarity and complexity of this condition, its management strategy is relatively simple. In the present study, we describe a case of a tongue abscess on the anterior two-thirds of the tongue in a 60-year-old woman, and discuss the pathophysiology, diagnosis, and treatment of this complex entity.

Assessment of the microbiota of a mixed infection of the tongue using phenotypic and genotypic methods simultaneously and a review of the literature

We assessed the microbiota of a tongue abscess in which twelve different aerobic and anaerobic bacteria were identified using fluorescent in situ hybridisation (FISH), sequencing of the 16S rRNA gene and phenotypic methods. By applying the 16S rRNA based probes directly on the clinical material, a quick insight of the bacteria present was obtained and the species which were not cultured but present in the abscess were identified.