Bekele Kebebe, Markos Desalegn
Department of Surgery, School of Medicine, Madda Walabu University, Bale Goba.
Department of Neonatology Nursing, St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Int Med Case Rep J. 2017 Aug 16;10:285-287. doi: 10.2147/IMCRJ.S140255. eCollection 2017.
Lingual abscesses have become extremely rare since the discovery of antibiotics, despite the relatively frequent exposure of tongue to bite trauma during mastication and seizures. It is a potentially life-threatening clinical entity. Even though there were some case reports on tongue abscess from overseas, none of them were reported from Africa, particularly from Ethiopia.
A 36-year-old male patient with severe, continuous pain and swelling of tongue for 6 weeks was presented to Goba Referral Hospital. The swelling was 2 cm by 1 cm, located on posterior central tongue, and frank pus oozed from the center of the swelling. He had associated dysphagia, odynophagia, and speech difficulty. He had no previous personal and family history of similar illness and tonsillitis. Gram staining revealed the presence of Gram-positive cocci in clusters. Pyogenic lingual abscess was the diagnosis. Treatment included incision and drainage with the administration of systemic antibiotics, which covered both aerobic and anaerobic organisms, and anti-pain drugs. The condition did not relapse in 6 months of follow-up.
Lingual abscess should be considered in patients presenting with tongue swelling, dysphagia, odynophagia, and speech difficulty. Since lingual abscess that occurs on the posterior part of the tongue has diagnostic difficulty, professionals in rural setup where diagnostic resources (such as ultrasound and magnetic resonance imaging) are scarce should be careful not to misdiagnose it. Incision and drainage with the administration of systemic antibiotics and anti-pain drugs is an effective treatment option for lingual abscess.
自从发现抗生素以来,舌部脓肿已变得极为罕见,尽管在咀嚼和癫痫发作期间舌头相对频繁地受到咬伤创伤。它是一种潜在的危及生命的临床病症。尽管国外有一些关于舌部脓肿的病例报告,但非洲,特别是埃塞俄比亚均未见相关报道。
一名36岁男性患者因舌部严重持续疼痛和肿胀6周就诊于戈巴转诊医院。肿胀部位为2厘米×1厘米,位于舌后部中央,肿胀中心有明显脓液渗出。他伴有吞咽困难、吞咽疼痛和言语困难。他既往无类似疾病和扁桃体炎的个人及家族史。革兰氏染色显示有革兰氏阳性球菌成簇存在。诊断为化脓性舌部脓肿。治疗包括切开引流,并给予覆盖需氧菌和厌氧菌的全身抗生素以及止痛药物。随访6个月病情未复发。
对于出现舌部肿胀、吞咽困难、吞咽疼痛和言语困难的患者应考虑舌部脓肿。由于发生在舌后部的舌部脓肿诊断存在困难,在缺乏诊断资源(如超声和磁共振成像)的农村地区,专业人员应注意避免误诊。切开引流并给予全身抗生素和止痛药物是治疗舌部脓肿的有效选择。