Challenges in the Diagnosis of a Posterior Lingual Abscess, a Potential Lethal Disorder: A Case Report and Review of the Literature.

A lingual abscess is a rare but potentially life-threatening disorder. Since the introduction of antibiotics, the incidence of posterior lingual abscesses has significantly declined; however, this condition is often missed on physical examination or misdiagnosed as another condition. The consequence of this misdiagnosis can be severe because airway obstruction with subsequent difficult or unattainable intubation can develop and lead rapidly to death. Being relatively rare yet potentially lethal, consideration of a lingual abscess at the time of autopsy is important; otherwise, it may be missed. During most autopsies, the base of the tongue is often examined grossly in a cursory fashion, if at all, and microscopic sections of this region are not commonly used. As this case report will illustrate, such an approach would most likely miss this important condition.

Atypical Presentation of Viral Gastroenteritis in a Three-year-old Child Due to a UNC80 Mutation.

We report a three-year-old child with a rare genetic phenomenon, a UNC80 mutation, who had an unusual presentation of viral gastroenteritis. The UNC80 gene encodes for an important voltage-independent channel in neurons and a mutation in this protein can lead to severe hypotonia. The hypotonia manifests as delayed gastric emptying, impaired respiratory clearance, and/or delayed muscle coordination, which can predispose to infection susceptibility. UNC80 gene mutations have also been shown to cause global developmental delays, failure to thrive, and phenotypic dysmorphisms. In our patient, we believe that his genetic defect precipitated a complicated hospital course. The patient's delayed gastric emptying caused difficulty in recovering from viral gastroenteritis while a concurrent pneumonia diagnosis required assistance in clearing respiratory contents. The UNC80 mutation is under-studied, and more studies are necessary to understand the clinical implications of its phenotypes.