Acute tongue swelling is an uncommon but important presenting complaint because it may represent a life-threatening disorder requiring emergent treatment. We present the case of a 52-year-old man with tongue swelling and pain who was initially diagnosed with angiotensin-converting enzyme inhibitor-induced angioedema but was later found to have a lingual abscess on a computed tomographic scan. Culture of the abscess grew oral flora, but blood cultures grew Abiotrophia/Granulicatella sp. These nutritionally variant streptococci (NVS) have not been previously reported in immunocompetent patients in the setting of lingual abscess. The patient ultimately did well after receiving needle drainage and antibiotics.
From the Departments of *Internal Medicine/Emergency Medicine and †Pediatrics/Internal Medicine, Christiana Care Health System, Newark, DE; and ‡Internal Medicine and Pediatrics, Jefferson Medical College, Philadelphia, PA.
Correspondence to: Matthew E. Stofferahn, MD, Internal Medicine/Emergency Medicine, Christiana Care Health System, Newark, DE. E-mail: firstname.lastname@example.org.
The authors have no funding or conflicts of interest to disclose.