1
|
Suzuki M, Eguchi K, Yoshida N. Parenchymatous glossitis: A case report. Clin Case Rep 2024; 12:e8909. [PMID: 38745732 PMCID: PMC11091011 DOI: 10.1002/ccr3.8909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/16/2024] Open
Abstract
We present a case of parenchymatous glossitis with unilateral severe inflammation of the hyoglossus muscle, resulting in laryngeal edema. The route of inflammation was unique. Contrast-enhanced CT was useful for diagnosis. Administration of sensitive antibiotics led to improvement. Creatine phosphokinase may be an indicator of diagnosis and treatment response.
Collapse
Affiliation(s)
- Masami Suzuki
- Department of Otolaryngology‐Head and Neck SurgeryJichi Medical University Saitama Medical CenterSaitamaJapan
| | - Kohtaro Eguchi
- Department of Head and Neck SurgeryNational Cancer Center HospitalTokyoJapan
| | - Naohiro Yoshida
- Department of Otolaryngology‐Head and Neck SurgeryJichi Medical University Saitama Medical CenterSaitamaJapan
| |
Collapse
|
2
|
Safia A, Shehadeh R, Merchavy S. Anterolateral Lingual Abscess in a Young Adult: A Comprehensive Case Study. EAR, NOSE & THROAT JOURNAL 2024:1455613241233922. [PMID: 38369962 DOI: 10.1177/01455613241233922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Lingual abscesses, characterized by infectious collections of pus within the tongue parenchyma, are rare and poorly understood clinical entities. Despite their potential for severe complications, literature on lingual abscesses remains limited, consisting mainly of sporadic case reports. This comprehensive case study examines the challenges and successful management of a severe anterolateral tongue abscess in a young adult, contributing to the emerging body of knowledge on this condition. A young adult male presented with a progressively worsening painful, swollen tongue and dyspnea over 2 days. Urgent intervention was necessary to prevent potential airway compromise despite maintaining normal oxygen saturation. The patient's medical history showed no prior oral infections, illnesses, or relevant medical conditions. Detailed clinical assessment, utilization of imaging modalities such as contrast-enhanced computed tomography scan and ultrasonography, and collaboration with a maxillofacial surgeon guided accurate diagnosis and successful treatment. This case study provides valuable insights into the diagnosis and management of anterolateral lingual abscess in a young adult. It underscores the importance of heightened clinical awareness, precise diagnostic techniques, and multidisciplinary collaboration for optimal patient outcomes. The report contributes to the limited literature and emphasizes the need for further research to establish evidence-based guidelines for lingual abscess management.
Collapse
Affiliation(s)
- Alaa Safia
- Department of Otolaryngology-Head and Neck Surgery Unit, Rebecca Ziv Medical Center, Safed, Israel
| | - Rabie Shehadeh
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Shlomo Merchavy
- Department of Otolaryngology-Head and Neck Surgery Unit, Rebecca Ziv Medical Center, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| |
Collapse
|
3
|
Rampi A, Tettamanti A, Bertotto I, Comini LV, Howardson BO, Luparello P, Di Santo D, Bondi S. Atypical Tongue Abscesses Mimicking Submucosal Malignancies: A Review of the Literature Focusing on Diagnostic Challenges. Cancers (Basel) 2023; 15:5871. [PMID: 38136415 PMCID: PMC10741429 DOI: 10.3390/cancers15245871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Tongue abscesses are rare conditions that usually follow mucosal disruption due to mechanical trauma or foreign body impaction. They typically manifest abruptly as a rapidly growing, hard mass or swelling in the context of tongue muscles; the patient frequently complains of pain, difficulties in swallowing or speaking, and fever. Nonetheless, the features of its presentation, together with accurate clinical evaluation, blood tests, and appropriate imaging tests, are usually sufficient to easily discern a tongue abscess from a malignancy. However, in rare cases, they may occur with slowly progressing and subtle symptoms, nuanced objective and laboratory findings, and inconclusive radiological evidence, leading to difficult differential diagnosis with submucosal malignancy. Herein, we review the literature, available on Pubmed, Embase, and Scopus, on publications reporting tongue abscesses, with atypical presentation suggesting an oral tumor. Our review confirms that tongue abscesses may manifest as a slowly growing and moderately painful swelling without purulent discharge and minimal mucosal inflammation; in this case, they may constitute an actual diagnostic challenge with potentially severe impact on correct management. Atypical tongue abscesses must therefore be considered in the differential diagnosis of tongue malignancy with submucosal extension, even when other diagnostic elements suggest a neoplasia; in this case, a deep biopsy under general anesthesia is essential for differential diagnosis, and simultaneous drainage of the necrotic and abscessual material may resolve the condition.
Collapse
Affiliation(s)
- Andrea Rampi
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.R.); (A.T.); (B.O.H.)
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Alberto Tettamanti
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.R.); (A.T.); (B.O.H.)
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Ilaria Bertotto
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy;
| | - Lara Valentina Comini
- Otorhinolaryngology Unit, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy; (L.V.C.); (P.L.); (D.D.S.)
| | - Bright Oworae Howardson
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.R.); (A.T.); (B.O.H.)
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Paolo Luparello
- Otorhinolaryngology Unit, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy; (L.V.C.); (P.L.); (D.D.S.)
| | - Davide Di Santo
- Otorhinolaryngology Unit, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy; (L.V.C.); (P.L.); (D.D.S.)
| | - Stefano Bondi
- Otorhinolaryngology Unit, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy; (L.V.C.); (P.L.); (D.D.S.)
| |
Collapse
|
4
|
Datta D, Chatterjee D, Tiwari M. Lingual Abscess after Posterior Fossa Surgery: An Unusual Complication of the Concorde Position. Asian J Neurosurg 2023; 18:810-812. [PMID: 38161605 PMCID: PMC10756768 DOI: 10.1055/s-0043-1776299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Posterior fossa tumors are one of the most common tumors occurring in children. These tumors are often operated in the Concorde or prone position. Venous congestion can occur due to neck flexion during the positioning causing macroglossia. We report a case of a lingual abscess in a child after surgery in the Concorde position. There was no preoperative evidence of any lingual and dental complaints or injury during intubation. We hypothesize that the lingual abscess in the immediate postoperative period was secondary to venous stasis during the positioning for surgery.
Collapse
Affiliation(s)
- Debajyoti Datta
- Department of Neurosurgery, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Debarshi Chatterjee
- Department of Neurosurgery, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Mona Tiwari
- Department of Radiology, Institute of Neurosciences, Kolkata, West Bengal, India
| |
Collapse
|
5
|
Bal KK, Gür H, Demir I, Ismi O, Vayisoglu Y, Gorur K, Ozcan C, Unal M. Mortal condition in an unusual localization, analysis of isolated tongue and tongue base abscesses. World J Clin Cases 2023; 11:7778-7784. [PMID: 38073684 DOI: 10.12998/wjcc.v11.i32.7778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/18/2023] [Accepted: 11/02/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Tongue abscess (TA) is a very rare clinical condition and its treatment is very important. Surgical drainage is at the forefront in the treatment. Our study includes patients with tongue and tongue base abscesses.
AIM To discuss the clinical and laboratory findings of these patients emphasizing the underlying causes and treatment options with the largest patient series in the English literature.
METHODS We included patients with isolated TA who applied to our clinic between January 1, 2020 and January 1, 2023. Those who lack the recorded data, those who are not between the ages of 18-66, those who have not undergone surgery-interventional procedure, and those who have infection and/or abscess in another place were excluded from the study.
RESULTS There were two female (18%) and nine male (82%) patients in our series consisting of 11 patients. Their ages ranged from 18 to 66, and the mean ± SD was 48.63 ± 16.3. Considering the localization of the abscess, three anterior abscesses (27%), two lateral abscesses (18%), and six abscesses at the base of the tongue (54%) were detected.
CONCLUSION Tongue abscesses can cause acute upper airway obstruction and respiratory collapse. It may be necessary to act quickly for the tracheotomy procedure and this procedure can usually be performed under local anesthesia as intubation cannot be achieved. When we encounter an abscess in an unexpected organ, difficulties may be encountered in the management of the patient.
Collapse
Affiliation(s)
- Kemal Koray Bal
- Department of Otorhinolaryngology, Mersin University, Mersin 33160, Mersin, Turkey
| | - Harun Gür
- Department of Otorhinolaryngology, Mersin University, Mersin 33160, Mersin, Turkey
| | - Ibrahim Demir
- Department of Otorhinolaryngology, Mersin University, Mersin 33160, Mersin, Turkey
| | - Onur Ismi
- Department of Otorhinolaryngology, Mersin University, Mersin 33160, Mersin, Turkey
| | - Yusuf Vayisoglu
- Department of Otorhinolaryngology, Mersin University, Mersin 33160, Mersin, Turkey
| | - Kemal Gorur
- Department of Otorhinolaryngology, Mersin University, Mersin 33160, Mersin, Turkey
| | - Cengiz Ozcan
- Department of Otorhinolaryngology, Mersin University, Mersin 33160, Mersin, Turkey
| | - Murat Unal
- Department of Otorhinolaryngology, Mersin University, Mersin 33160, Mersin, Turkey
| |
Collapse
|
6
|
Saro-Buendía M, Suarez Urquiza P, Amigo González J, Lesmas Navarro MJ, Mazón M, Armengot Carceller M. Posterior Lingual Abscess; Report of Two Cases. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2023; 11:e18. [PMID: 36743702 PMCID: PMC9887229 DOI: 10.22037/aaem.v11i1.1860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The lingual abscess is rare due to several protective mechanisms against infection in this location. Concretely, the abscess in the base of the tongue (posterior lingual abscess) is even more exceptional. Its prompt detection is crucial to avoid potentially fatal airway complications. To familiarize physicians with this condition, we report 2 cases of posterior lingual abscess. Both were referred to our emergency department due to minor oropharyngeal complaints. Finally, both were diagnosed and required surgical drainage. The clinical evolution was successful: both were discharged in less than 72 hours and follow-up one week later confirmed clinical recovery.
Collapse
Affiliation(s)
- Miguel Saro-Buendía
- Department of Otorhinolaryngology, La Fe University and Polytechnic Hospital, Valencia, Spain.,Department of Surgery, Faculty of Medicine, University of Valencia, Spain.,Corresponding author: Miguel Saro- Buendía; Fernando Abril Martorell Avenue, 106, Postal Code 46026. , ORCID: 0000-0003-4794-3615, Phone: +34-671 688 648
| | - Pedro Suarez Urquiza
- Department of Microbiology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Judit Amigo González
- Department of Internal Medicine, La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - Miguel Mazón
- Department of Radiology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Miguel Armengot Carceller
- Department of Otorhinolaryngology, La Fe University and Polytechnic Hospital, Valencia, Spain.,Department of Surgery, Faculty of Medicine, University of Valencia, Spain
| |
Collapse
|
7
|
Mesfin T, Debele G, Seyoum K, Dadi S, Tsegaye M, Gomora D, Kene C, Tolosa G. Tongue Abscess: A Case Report. Int Med Case Rep J 2022; 15:769-772. [PMID: 36605725 PMCID: PMC9809373 DOI: 10.2147/imcrj.s399020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction Abscess of the tongue is a very rare disease that potentially compromises the airway. Acute tongue abscess symptoms include swelling or a lump in the deep tissues of the tongue, throbbing local pain, a discomfort that radiates to the ears, fever, difficulty swallowing, deliberate fixation of the tongue due to pain, and eventually, difficulties breathing. Case This is a 50-year-old male patient who presented with a complaint of severe tongue pain and swelling of three days duration. Associated with this, he had pain while swallowing, difficulty opening his mouth, shortness of breath, and drooling saliva. Likewise, he had a high-grade fever and a global type of headache. On physical examination, there was significant tongue swelling on the left anterolateral area, fluctuant on palpation, and had erythematous border. After informed consent was taken the patient was transferred to the operation room with the diagnosis of tongue abscess. Subsequently, incision and drainage were done under general anesthesia, and about 30mL of thick pus was drained. The pocket was washed with normal saline and 2% hydrogen peroxide. The patient was transferred to the surgical ward with stable vital signs and had been on antibiotics. He was discharged after two days of hospital stay. Conclusion Abscesses in the tongue are quite uncommon due to its rich vascular supply, lymphatic drainage, and saliva's immunologic advantage. Thorough diagnosis and successful treatment of tongue abscess prevent potential airway compromise. Antibiotic treatment should cover gram-positive and gram-negative anaerobes.
Collapse
Affiliation(s)
- Telila Mesfin
- Department of Medicine, Madda Walabu University Goba General Hospital, Goba, Ethiopia,Correspondence: Telila Mesfin, Tel +251931504321, Email
| | - Gosaye Debele
- Department of Surgery, Madda Walabu University Goba General Hospital, Goba, Ethiopia
| | - Kenbon Seyoum
- Department of Midwifery, Madda Walabu University Goba General Hospital, Goba, Ethiopia
| | - Sisay Dadi
- Department of Internal Medicine, Madda Walabu University Goba General Hospital, Goba, Ethiopia
| | - Mesfin Tsegaye
- Department of Medicine, Madda Walabu University Goba General Hospital, Goba, Ethiopia
| | - Degefa Gomora
- Department of Midwifery, Madda Walabu University Goba General Hospital, Goba, Ethiopia
| | - Chala Kene
- Department of Midwifery, Madda Walabu University Goba General Hospital, Goba, Ethiopia
| | - Gudisa Tolosa
- Department of Medicine, Madda Walabu University Goba General Hospital, Goba, Ethiopia
| |
Collapse
|
8
|
Carotenuto A, Menke B, Jolton J, Dowdall JR. Recurrent Lingual Abscess in an Elderly Female With Bulbar Amyotrophic Lateral Sclerosis. Cureus 2022; 14:e28280. [PMID: 36158411 PMCID: PMC9492446 DOI: 10.7759/cureus.28280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 11/05/2022] Open
Abstract
A lingual abscess is a rare condition that was scarcely described in clinical textbooks. A lingual abscess recurrence is rare and has only been described twice in the literature. Typically, the tongue and oral cavity have multiple intrinsic properties which stave off intralingual infection; however, there may be situations in which these properties are compromised, as demonstrated in oro-motor disability. Lingual abscesses have the potential to develop into catastrophic obstructive airway issues; therefore, early detection and management are paramount. The following is a presentation of an elderly female with Bulbar Amyotrophic Lateral Sclerosis (ALS) treated conservatively for a lingual abscess with recurrence at eleven months post-treatment. Due to her baseline neuromuscular disorder and elevated anesthesia risk, she was treated in the interventional radiology suite with drain placement and Povidone-Iodine sclerotherapy under conscious sedation with excellent results.
Collapse
|
9
|
Lingual abscess: A case report of a rare clinical entity. OTOLARYNGOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.xocr.2022.100411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
10
|
Khoury M, Dong SX, Alsaffar H, Johnson-Obaseki S, Caulley L. Isolated oropharyngeal abscess with hypopharyngeal extension recurring 12 years after initial surgical management: A case report and review of the literature. SAGE Open Med Case Rep 2022; 10:2050313X221089119. [PMID: 35401981 PMCID: PMC8984837 DOI: 10.1177/2050313x221089119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/04/2022] [Indexed: 11/17/2022] Open
Abstract
Pharyngeal abscesses require urgent management as they have the propensity to cause severe and life-threatening complications. The introduction of antibiotics has led to a dramatic decline in the incidence of these infections. Regardless, abscess formation continues to be observed in the peritonsillar, parapharyngeal, and retropharyngeal spaces. Oropharyngeal and hypopharyngeal abscesses that cause airway obstruction are scarcely reported and tend to be secondary to other processes. Herein, we describe the case of an 83-year-old man presenting with an idiopathic, obstructive, oropharyngeal wall abscess, extending from the infratonsillar region to the hypopharynx, which recurred after initial surgical management 12 years prior for the same process. He required reintervention during both episodes for rapid reaccumulation. A detailed electronic literature search of PubMed and MedLine was performed for studies reporting on recurrent pharyngeal abscesses and their management. Results were limited to articles published in English from inception to August 2021. The timely management of pharyngeal infections acutely obstructing the airway is crucial. Physicians should adopt close and frequent monitoring and have a low threshold for reimaging should symptoms worsen or fail to improve after the initial surgical intervention.
Collapse
Affiliation(s)
- Michel Khoury
- Department of Undergraduate Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Selina Xiangxu Dong
- Department of Undergraduate Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Hussain Alsaffar
- Department of Otolaryngology—Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Stephanie Johnson-Obaseki
- Department of Otolaryngology—Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Lisa Caulley
- Department of Otolaryngology—Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Knowledge Synthesis Group, Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| |
Collapse
|
11
|
Mesolella M, Allosso S, Iorio B, Motta G. Clinical and Diagnostic Aspect of Tongue Abscess. EAR, NOSE & THROAT JOURNAL 2020; 100:1012S-1014S. [PMID: 32527144 DOI: 10.1177/0145561320933961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Massimo Mesolella
- Department of Neurosciences, "Federico II" University, ENT Section, Naples, Italy
| | - Salvatore Allosso
- Department of Neurosciences, "Federico II" University, ENT Section, Naples, Italy
| | - Brigida Iorio
- Department of Neurosciences, "Federico II" University, ENT Section, Naples, Italy
| | - Gaetano Motta
- Department of Mental and Physical Health and Preventive Medicine, Head and Neck Surgery Unit, University of Campania "Luigi Vanvitelli," Campania, Italy
| |
Collapse
|
12
|
Awai S, Miller BJ, Dimitrov L, Williamson AJ. Lingual tonsil abscess: a rare, life-threatening cause of acute sore throat. BMJ Case Rep 2019; 12:12/5/e229555. [PMID: 31126932 DOI: 10.1136/bcr-2019-229555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Shashi Awai
- Department of ENT, East Surrey Hospital, Redhill, UK
| | | | - Lilia Dimitrov
- Department of ENT, Imperial College Healthcare NHS Trust, London, UK
| | | |
Collapse
|