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患有皮埃尔·罗宾序列征的成年患者的舌部脓肿:一例报告

Lingual Abscess in an Adult Patient With Pierre Robin Sequence: A Case Report.

作者信息

Plata-Huerta Hiram H, Rosero-Castillo Astrid E, Trevino Gonzalez Jose Luis

机构信息

Otolaryngology - Head and Neck Surgery, Hospital Universitario Dr. José Eleuterio González, Universidad Autonoma de Nuevo Leon, Monterrey, MEX.

出版信息

Cureus. 2024 Jul 26;16(7):e65460. doi: 10.7759/cureus.65460. eCollection 2024 Jul.

DOI:10.7759/cureus.65460
PMID:39184796
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11345102/
Abstract

A lingual abscess is a rare but serious infection within the tongue parenchyma, posing significant risks due to potential airway obstruction. Despite advancements in oral hygiene and antibiotics, timely diagnosis and treatment are critical to prevent severe complications. In this case, we report a 29-year-old male with Pierre Robin sequence (PRS) who presented with a four-day history of severe tongue pain, swelling, decreased appetite, and fever, without any reported trauma. Examination revealed left-sided tongue swelling, poor oral hygiene, and notable Mallampati III classification. A neck CT scan confirmed an abscess in the left hemitongue involving the intrinsic and mylohyoid muscles, measuring 26.5 x 30 x 30.5 mm with a volume of approximately 8 cc. Prompt intravenous antibiotic treatment was initiated, leading to spontaneous abscess drainage and significant clinical improvement. The patient was discharged after five days of intravenous antibiotics and continued oral antibiotics. At one-week follow-up, he was asymptomatic and fully recovered. This case underscores the importance of recognizing the potentially life-threatening nature of lingual abscesses, particularly in syndromic patients like those with PRS, who may experience quicker airway obstruction due to craniofacial abnormalities, such as micrognathia and glossoptosis. Given the rarity of such conditions, awareness and readiness to address these emergencies are essential for ensuring patient safety and positive outcomes.

摘要

舌部脓肿是一种罕见但严重的舌实质内感染,由于可能导致气道阻塞而具有重大风险。尽管口腔卫生和抗生素方面取得了进展,但及时诊断和治疗对于预防严重并发症至关重要。在本病例中,我们报告了一名患有皮埃尔·罗宾序列征(PRS)的29岁男性,他有四天严重舌痛、肿胀、食欲减退和发热的病史,无任何外伤报告。检查发现左侧舌部肿胀、口腔卫生差,且马兰帕蒂分级为III级。颈部CT扫描证实左侧半舌有脓肿,累及舌固有肌和下颌舌骨肌,大小为26.5×30×30.5毫米,体积约8立方厘米。立即开始静脉抗生素治疗,脓肿自发引流,临床症状显著改善。患者在接受五天静脉抗生素治疗并继续口服抗生素后出院。在一周的随访中,他无症状且已完全康复。本病例强调了认识舌部脓肿潜在危及生命性质的重要性,尤其是在患有PRS等综合征的患者中,由于颅面异常,如小颌畸形和舌后坠,他们可能更快出现气道阻塞。鉴于此类情况罕见,认识并随时准备应对这些紧急情况对于确保患者安全和取得良好结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/359e/11345102/210665e880f0/cureus-0016-00000065460-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/359e/11345102/cb6b2e158b43/cureus-0016-00000065460-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/359e/11345102/73cd35974c07/cureus-0016-00000065460-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/359e/11345102/210665e880f0/cureus-0016-00000065460-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/359e/11345102/cb6b2e158b43/cureus-0016-00000065460-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/359e/11345102/73cd35974c07/cureus-0016-00000065460-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/359e/11345102/210665e880f0/cureus-0016-00000065460-i03.jpg

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本文引用的文献

1
Atypical Tongue Abscesses Mimicking Submucosal Malignancies: A Review of the Literature Focusing on Diagnostic Challenges.模仿黏膜下恶性肿瘤的非典型舌部脓肿:聚焦诊断挑战的文献综述
Cancers (Basel). 2023 Dec 17;15(24):5871. doi: 10.3390/cancers15245871.
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Posterior Lingual Abscess; Report of Two Cases.舌后脓肿;两例报告
Arch Acad Emerg Med. 2023 Jan 14;11(1):e18. doi: 10.22037/aaem.v11i1.1860. eCollection 2023.
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The management of upper airway obstruction in Pierre Robin Sequence.皮埃尔·罗宾序列征中上气道梗阻的管理
Paediatr Respir Rev. 2023 Mar;45:11-15. doi: 10.1016/j.prrv.2022.07.001. Epub 2022 Jul 9.
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Challenges in the Diagnosis of a Posterior Lingual Abscess, a Potential Lethal Disorder: A Case Report and Review of the Literature.舌后脓肿诊断面临的挑战——一种潜在致命性疾病:病例报告及文献综述
Am J Forensic Med Pathol. 2020 Mar;41(1):64-66. doi: 10.1097/PAF.0000000000000514.
5
Lingual Abscess: Predisposing Factors, Pathophysiology, Clinical Manifestations, Diagnosis, and Management.舌部脓肿:诱发因素、病理生理学、临床表现、诊断及治疗
Int J Otolaryngol. 2018 Nov 7;2018:4504270. doi: 10.1155/2018/4504270. eCollection 2018.
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The First Patient Report of Tongue Abscess Among Iraqi Population.
J Craniofac Surg. 2018 May;29(3):e243-e245. doi: 10.1097/SCS.0000000000004257.
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Lingual abscess: a case report.舌部脓肿:一例病例报告。
Int Med Case Rep J. 2017 Aug 16;10:285-287. doi: 10.2147/IMCRJ.S140255. eCollection 2017.
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Recurrent Lingual Abscess in a Child.一名儿童复发性舌部脓肿
Pediatr Infect Dis J. 2017 Jul;36(7):694-695. doi: 10.1097/INF.0000000000001515.
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Glossoptosis.舌后坠
Semin Pediatr Surg. 2016 Jun;25(3):123-7. doi: 10.1053/j.sempedsurg.2016.02.002. Epub 2016 Feb 18.
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A rare cause of acute Dysphagia: abscess of the base of the tongue.急性吞咽困难的罕见病因:舌根脓肿。
Case Rep Gastrointest Med. 2015;2015:431738. doi: 10.1155/2015/431738. Epub 2015 Feb 23.