Deep Lingual Abscess Involving Extrinsic Tongue Muscles Without Visible Swelling: A Diagnostic and Airway Challenge

Abstract

Lingual abscesses are rare infections that may present without overt mucosal swelling, particularly when involving deep extrinsic tongue musculature. These atypical cases pose significant diagnostic and airway management challenges.

 Case report: A 54-year-old male presented with fever, odynophagia, and painful tongue movements without visible swelling. Contrast-enhanced computed tomography (CECT) revealed a deep lingual abscess involving the extrinsic muscles. The patient underwent transoral surgical drainage and was treated with intravenous antibiotics, resulting in rapid clinical improvement.

 Conclusion: A high index of suspicion, supported by prompt imaging, is critical for diagnosing deep lingual abscesses. Early surgical intervention prevents airway compromise and ensures favorable outcomes.