Abscess of the tongue is a local purulent-necrotic inflammation, which is characterized by the formation of an abscess in the thickness of the tongue, surrounded by an infiltrative capsule. An abscess is a cavity with purulent exudate, which is limited by a pyogenic membrane. Tongue abscess is very common in the practice of a dental surgeon. In most cases, an abscess appears due to the penetration of pyogenic microflora through the tissues of the tongue, which are damaged.
Causes of the development of a purulent abscess of the tongue
Tongue abscess is one of the most dangerous purulent inflammations of the oral cavity, especially when it is located at the root of the tongue. In the absence of timely and adequate treatment, a purulent abscess of the tongue can have extremely unpleasant consequences.
The main cause of an abscess is a bacterial infection. Staphylococci, streptococci and anaerobic flora are the main etiological agents. For the penetration and spread of infection, the entrance gate is needed, which serve as wounds. Damage to the integrity of the mucous membranes occurs as a result of injuries of various nature - damage to the mucous membrane of the tongue with bones from fish, incorrectly placed prostheses, sharp edges of the teeth.
Also inflammation of the tissues of the tongue is possible with the transition of the inflammatory process from the side of the lower front teeth, for example, with purulent periodontitis. A purulent abscess of the tongue can become a complication of glossitis, acute tonsillitis, ulcerative stomatitis.
In addition, the development of a purulent abscess of the tongue can be triggered by infection through an uncovered opening of the tongue (blink hole).
Due to the anatomical structure of the tongue, an infection that starts in one half of the tongue very rarely spreads to the other side. The reason for this is the fibrous septa that separate the muscle groups.
Clinical manifestations of the development of a purulent abscess of the tongue
Purulent abscess of the tongue can be superficial and deep. A superficial abscess is localized just below the mucosa. In the presence of a superficial abscess, the patient feels a sharp pain when swallowing, which can sometimes radiate to the ear. On examination, an area of edematous tissue is visualized, hyperemic and painful on palpation. Such abscesses often open on their own, after which the condition is relieved.
Deep purulent abscess is located in the tissue of the tongue. For this form of abscess, a deterioration in the general condition is characteristic: sleep disturbance, weakness, general malaise, tachycardia, fever, chills. There is an increase in lymph nodes (submandibular and submental).
Characteristically profuse salivation, soreness and swelling of the tongue. The mucous membrane of the tongue acquires a bluish tint, becomes covered with a purulent coating, an unpleasant putrefactive odor is felt from the mouth.
At the same time, the tongue greatly increases in size, sometimes to such a size that it hardly fits in the mouth. Speech becomes slurred and breathing becomes difficult. This creates a feeling of fear in the patient. Often the patient takes a forced sitting position. If a purulent abscess of the tongue often recurs, this is a sign of non-closure of the blind hole.
Diagnosis and treatment of abscess. Possible complications of a tongue abscess
A tongue abscess is diagnosed based on the history and physical examination. From laboratory tests, a general blood test is sufficient, which will show the presence of inflammation and its activity. To determine the type and sensitivity of pathogens, a microbiological culture is carried out from the abscess.
Differential diagnosis should be carried out with phlegmon of the oral cavity (Ludwig's angina) and abscessing lymphadenitis of the submental lymph nodes.
Abscess can be treated conservatively or surgically. Treatment of an abscess begins with rinsing the mouth with antiseptic solutions, taking antibacterial drugs. If these methods of treating an abscess do not bring effect, a surgical opening of the abscess of the tongue is performed. As a rule, in most cases, conservative therapy helps to avoid surgery.
With timely treatment, the treatment of an abscess with a conservative method is possible for two weeks without complications. In advanced conditions, treatment is long and difficult. In addition, the possibility of developing complications - mediastinitis, sepsis and phlegmon increases. Such complications can be fatal.
In order to prevent tongue abscess, it is necessary to observe the rules of oral hygiene and avoid injury to tissues in the oral cavity. If you find the first signs of inflammation, you need to contact a specialist.
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