Background
Tongue necrosis is a rare entity as the tongue is a highly vascularized
structure supplied by the lingual artery, a branch of the external
carotid artery. Tongue necrosis typically presents with unilateral
lingual pain, swelling, discoloration and, in severe cases, necrosis.
There are many underlying factors that can contribute to the development
of tongue necrosis (Table 1). Giant cell arteritis (GCA), ANCA
(Anti-Neutrophil Cytoplasmic Antibody)-associated vasculitis and other
vasculitides have been previously described as underlying systemic
causes of tongue necrosis [1-4]. Other potential causes include
infection (particularly tuberculosis and syphilis), malignancy,
radiation therapy, use of vasoconstricting medications and systemic
hypoperfusion such as in the setting of shock [1]. This case report
adds histoplasmosis to this list of differential diagnoses.