Lingual abscess: A case report of a rare clinical entity

Background: Lingual abscess is an exceptionally rare disease seldom encountered in the modern era. Due to the potential for life-threatening airway obstruction, increased awareness of this clinical entity is crucial to facilitate prompt recognition and diagnosis. We describe the case of a large lingual abscess along with a review of the literature regarding its presentation, clinical course and treatment modalities. Case presentation: A 55-year-old male presented with a 5-day history of progressively worsening odynophagia, revealed to be a 2.7 x 2.5 cm anterior lingual abscess on diagnostic imaging. The patient underwent treatment with transoral needle-aspiration, but experienced rapid interval recurrence of the abscess. Successful resolution of the abscess was achieved with transcervical surgical drainage and the patient experienced an uncomplicated post-operative course with complete resolution of symptoms. Conclusion: The present case highlights the need for a thorough history and careful exam of the entire oral cavity in all patients presenting with odynophagia, lingual tenderness or pain/swelling of the floor of mouth. Open surgical drainage with appropriate antibiotic therapy is recommended to achieve definitive resolution of lingual abscess.