Acute tongue abscess: Report of two cases

Jungell, Peter; Asikainen, Sirkka; Kuikka, Arja; Malmström, Maria

doi:10.1016/s0901-5027(06)80063-9

Cited by 9 publications

(7 citation statements)

References 14 publications

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“…The predisposing factor was also identified by posttraumatic dental procedure and odontogenic infection. Data confirmed that history taking, physical examination, and needle aspiration can provide the exact diagnosis [ 3 , 6 , 11 , 17 ]. In addition, contrast-enhanced CT scan was helpful in diagnosing [ 6 , 18 ].…”

Section: Resultsmentioning

confidence: 75%

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

Srivanitchapoom

Yata

2018

International Journal of Otolaryngology

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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.

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Section: Resultsmentioning

confidence: 75%

“…There were 5 case series of 13 patients that correlated with this study ( Table 3 ) [ 3 , 6 , 11 , 17 , 18 ]. According to the articles, thirteen patients (nine men and four women) were identified, three of which were children.…”

Section: Resultsmentioning

confidence: 99%

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

Srivanitchapoom

Yata

2018

International Journal of Otolaryngology

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“…Presentation with acute symptoms is uncommon for tongue tumors, but hemorrhage into the lesion may cause acute symptoms. On the other hand, abscess generally presents with swelling or a lump in the deep tissues of the tongue, pain radiating toward the ears, throbbing local pain, fever, difficulty in swallowing, voluntary fixation of the tongue because of pain, and, later, difficulty in breathing (3,4,10).…”

Section: Discussionmentioning

confidence: 99%

“…With multidetector CT; one can get excellent reformatted images (5). MRI is superior to CT in revealing the anatomy of the oral cavity (4,5,10,11). Moreover, diffusionweighted MRI may be used to help in the characterization of head and neck lesions, and its findings may provide useful supplementary information before surgery or biopsy (12).…”

Section: Discussionmentioning

confidence: 99%

Tongue metastasis mimicking abscess: a case report

Mavili

Öztürk²,

Yucel³

et al. 2008

Diagn Interv Radiol

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A lthough primary carcinomas of the tongue accounts for nearly 50% of oral carcinomas, tongue metastasis with acute swelling of the tongue as the initial manifestation of a lung cancer is extremely rare (1, 2). The differential diagnosis of acute tongue swelling includes hemorrhage, infarction, abscess, tumor, and edema (3). Several imaging techniques, including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), can be used to evaluate tongue swellings (4,5). CT is a useful tool for oral lesions, but MRI is superior in revealing the oral anatomy with excellent soft tissue detail and multiplanar capability (5); however, it is difficult to differentiate tongue abscess from malignancy on MRI because of the non-specific low signal intensity of the lesions on T1-weighted (W) images, and high signal intensity on T2W MR images (6).Herein we report the case of a lingual metastasis from lung cancer that presented with acute tongue swelling and respiratory distress, and mimicked abscess on CT and MRI. Case reportA 58-year-old woman was referred to the emergency department with swelling and pain of the tongue, and difficulty in breathing. Her symptoms were present for three months prior to presentation, but there was a recent sharp increase in swelling and difficulty in breathing. On physical examination, it was difficult to open her mouth; the right side of the tongue was diffusely swollen and indurated. The overlying mucosa was intact and of normal color.A CT examination was performed, and a hypodense lesion was seen on the right anterior tongue (Fig. 1). For further characterization of the lesion, nonenhanced and contrast-enhanced MRI examination was done. The lesion was hypointense on T1W precontrast images, and hyperintense on T2W images (Fig. 2a). There was an incomplete irregular, thick, hypointense rim on T2W images (Fig. 2b). This rim was not seen on T1W images. After contrast administration, the lesion showed marked peripheral contrast enhancement, but the central part did not enhance (Fig. 2c).With these clinical and radiological findings, the lesion appeared to be an abscess. An attempt was made to drain the lesion, but it was unsuccessful. Therefore, the material obtained from this procedure was sent for cytological evaluation. Cytopathological examination revealed clusters of atypical cells showing cytoplasmic vacuolization and forming adenoid structures suggestive of metastatic adenocarcinoma.A chest CT examination was performed to locate the primary source of this lesion. On CT, there was a 3.5 x 2.5 cm right hilar mass (Fig. 3), and small metastatic nodules in the lung parenchyma. Cytological examination of the specimen obtained by bronchial brushing performed during endoscopy revealed adenocarcinoma. Based on these findings, ABSTRACT Primary tumors metastasizing to the oral cavity are extremely rare. Lung is one of the most common primary sources of metastases to the tongue. Although the incidence of lung cancer is increasing, tongue metastasis as the initial presentation of ...

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“…7,14 Incision and drainage successfully treates most tongue abscesses, but depending on the clinical situation, some tonuge abscesses have been successfully treated with needle aspiration with adjunctive antibiotic therapy on an outpatient basis. 4,8,15 Antibiotic selection should cover oral flora, Staphylococcus, and Streptococcus. Amoxicillin clavulanate would cover P. multocida as well as Staphylococcus amd Streptococcus more commonly encountered and would probably be the best empiric choice for suspected tongue abscess.…”

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confidence: 99%

Clinical Pearls Painful Tongue Swelling

Ho¹,

Bush²

2000

Academic Emergency Medicine

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Figures 1 and 2. The patient's tongue on physical examination.Chief Complaint. Painful, swollen tongue. History of Present Illness.A 27-year-old man presents with a four-day history of progressive leftsided tongue swelling and pain. He additionally has difficulty handling oral secretions, and odynophagia. He denies trauma, fevers, chills, sore throat, dysphagia, or vomiting. He denies prior oral infections or recent illnesses. Past medical history is unremarkable. He has no pror surgeries or medical conditions.He is not currently taking medications and has no known allergies. Social history is significant for social alcohol use and smoking. He denies intravenous drug abuse. No HIV risk factors are identified.Physical Examination. The patient positions himself in a tripod position while wiping off saliva that drools continuously from his mouth. He appears awake and alert but is fatigued and dehydrated. His voice is muffled and he appears to have difficulty breathing. Vital signs show a blood pressure of 141/79 mm Hg, pulse rate of 82 beats/min, respiratory rate of 32 breaths/min, and temperature of 99.1ЊF (oral). Head and neck examination is significant for a fluctuant and exquisitely tender mass on the left side of the tongue (Figs. 1 and 2). The tongue is not erythematous and no external lesions are present. There is no tongue elevation or brawny edema of the submandibular region. Dentition is poor but no dental infections are evident. The oropharynx is otherwise clear with normal-appearing tonsils. Cervical lymph nodes are Laboratory. The white blood cell count is 14,000/L. No differential is obtained. The remainder of the complete blood cell count is normal. The serum potassium is 2.9 mmol/L. The remainder of the basic metabolic panel is normal.Radiologic and additional tests are performed.(The diagnosis, clinical course, discussion, and clinical pearls appear on page 941.)

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Acute tongue abscess: Report of two cases

Cited by 9 publications

References 14 publications

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

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

Tongue metastasis mimicking abscess: a case report

Clinical Pearls Painful Tongue Swelling

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