This is a rare case report of 37 years old lady presented with acute airway compromise after presenting a few times to the emergency department with worsening sore throat and been treated for tonsillitis. Patient oral examination was difficult due to severe truisms but no signs of tonsillitis.
Naso-endoscopic examination showed severe swelling of the base of the tongue without any significant signs of recent trauma or other signs of the acute inflammatory process. Imaging showed large posterior tongue base abscess. Drainage of the abscess was achieved through the external approach.
The patient recovered well and was discharged home on oral antibiotics. The condition was related to patent foramen caecum of small area which led to abscess formation due to canalisation of bacteria with no obvious source of trauma or oral infections.
In most cases the area involved is anterior part of the tongue. This case report will add to the understanding of the pathophysiological process of such usually sterile area of the tongue at the base.