Clinical course and imaging-guided medical treatment of a posterior lingual abscess: A rare but manageable deep neck infection.

Introduction and importance: Lingual abscesses are rare but can be life-threatening due to potential airway obstruction. Timely recognition is crucial for effective management. We present a case of a lingual abscess and review its clinical presentation, progression, and treatment options. Case presentation: A 38-year-old man with no significant medical history presented with a seven-day progression of worsening odynophagia and dysphagia. He had received prior empirical treatment with antibiotics and corticosteroids without improvement. Physical examination revealed swollen speech and limited tongue protrusion. Computed tomography (CT) identified a posterior lingual abscess. The patient received medical treatment based on amoxicilline-clavulanic acid, leading to successful resolution of symptoms and the abscess within 8 days. Clinical discussion: This case underscores the importance of considering lingual abscesses in patients with odynophagia and dysphagia. Due to their rarity and nonspecific symptoms, diagnosis can be challenging. Imaging studies, particularly CT scans, are essential for accurate diagnosis and guiding treatment strategies. Conclusion: Early intervention is vital to prevent complications such as airway obstruction. While surgical drainage is often recommended, some cases may resolve with medical management alone, as demonstrated in this patient. Clinicians should maintain a high index of suspicion for lingual abscesses to ensure prompt and appropriate treatment.