A 34-year-old man was admitted with a three-day history of fever and sore throat. He had a history of palatine tonsillectomy. A physical examination revealed left anterior cervical lymphadenopathy; however, an oral examination appeared normal. Blood test showed leukocytosis (10,780/μL) and C-reactive protein elevation (19.43 mg/dL). A pharyngo-laryngeal examination by fiberoptic laryngoscopy revealed bilateral lingual tonsillitis with pus (Picture). Blood cultures turned negative. His symptoms completely resolved with a seven-day course of ceftriaxone.
Picture.
Lingual tonsillitis is a rare cause of sore throat. Two-thirds of patients are reported to have a history of palatine tonsillectomy or adenoidectomy (1). Lingual tonsillitis can be overlooked because the lingual tonsils cannot be visualized on routine intraoral examination. This disease should be highly suspected based on the typical clinical presentation, which includes severe sore throat, dysphagia, and tenderness at the level of the hyoid bone. Laryngoscopy is required for a definitive diagnosis (2). Potentially fatal epiglottitis and abscess formation should be excluded.
The authors state that they have no Conflict of Interest (COI).
References
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