Lingual abscess from a grill cleaning brush bristle

Area of Science:

• Medicine
• Surgery
• Emergency Medicine

Background:

• Lingual abscesses are uncommon and can present with severe pain, potentially mimicking other conditions like glossopharyngeal neuralgia.
• Retained foreign bodies, such as fish bones, are known causes of lingual abscesses.
• Textbooks often lack detailed descriptions of lingual abscesses, contributing to diagnostic challenges.

Observation:

• A patient presented with severe tongue and ear pain, initially diagnosed as glossopharyngeal neuralgia.
• The patient later developed acute neck swelling, altered mental status, and rapidly progressive airway edema.
• Radiographic imaging revealed a lingual abscess containing a linear foreign body, later identified as a grill cleaning brush bristle.

Findings:

• The patient's airway was secured, followed by emergent incision and drainage of the lingual abscess.
• Despite the foreign body not being located during surgery, the abscess and airway edema resolved completely.
• CT scanning confirmed the persistent presence of the grill brush bristle within the tongue.

Implications:

• This case highlights the importance of considering lingual abscess in patients with atypical head and neck pain presentations.
• Prompt diagnosis and management, including airway protection and abscess drainage, are critical for preventing life-threatening complications such as sepsis and airway compromise.
• This is the first reported case of a lingual abscess caused by a grill cleaning brush bristle, expanding the known etiology of this rare condition.