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Clinical course and imaging-guided medical treatment of a posterior lingual abscess: A rare but manageable deep neck infection

Year: 2025

Type: article

Abstract: Lingual abscesses are rare but can be life-threatening due to potential airway obstruction. Timely recognition is crucial for effective management. We present a case of a lingual abscess and review its clinical presentation, progression, and treatment options. A 38-year-old man with no significant medical history presented with a seven-day progression of worsening odynophagia and dysphagia. He had received prior empirical treatment with antibiotics and corticosteroids without improvement. Physical examination revealed swollen speech and limited tongue protrusion. Computed tomography (CT) identified a posterior lingual abscess. The patient received medical treatment based on amoxicilline-clavulanic acid, leading to successful resolution of symptoms and the abscess within 8 days. This case underscores the importance of considering lingual abscesses in patients with odynophagia and dysphagia. Due to their rarity and nonspecific symptoms, diagnosis can be challenging. Imaging studies, particularly CT scans, are essential for accurate diagnosis and guiding treatment strategies. Early intervention is vital to prevent complications such as airway obstruction. While surgical drainage is often recommended, some cases may resolve with medical management alone, as demonstrated in this patient. Clinicians should maintain a high index of suspicion for lingual abscesses to ensure prompt and appropriate treatment. • Lingual abscesses are rare, exact incidence data are limited, lingual abscesses account for less than 0.1 % of all deep neck space infections, according to retrospective case series and reviews in the otolaryngology literature. • While robust epidemiological data are limited, a systematic review published in 2023 identified just 73 cases across 53 studies over more than five decades. • It can be life-threatening due to potential airway obstruction. Timely recognition is crucial for effective management.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2025.112108

Authors: Malika El Omri, Nawress Thabet, Imene Boukattaya, Mouna Bellakhdher, Wassim Kermani

Institution: Hôpital Farhat Hached

Language: English

Topic: Otolaryngology and Infectious Diseases

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090