Lingual necrosis secondary to group a streptococcal necrotising infection

Tongue necrosis is a rare manifestation of Group A Streptococcal (GAS) infection. Only certain strains of GAS have been found to cause invasive disease in the form of necrotising skin and soft tissue infections. We present the case of an older woman who developed a sore throat and localised ulcer on the tongue, that rapidly progressed to lingual necrosis and spreading erythema in the neck and chest. Owing to rapid detection, she received timely surgical treatment and intravenous antibiotic therapy, making a full recovery. This report describes the unique presentation of lingual necrosis in GAS infection. It highlights the diagnostic challenges and emphasises the importance of early recognition of symptoms.