Sir.—Acute bacterial glossitis is a rare but extremely serious entity. To date, only a handful of case reports have appeared in the literature. A variety of causative organisms have been identified, including three cases of acute glossitis resulting from Haemophilus influenzae type B,1-3 two cases of suppurative glossitis from Pseudomonas species and hemolytic streptococci,4 and one case of glossitis associated with Trichomonas species.5 We report the first case, to our knowledge, of acute glossitis and associated bacteremia caused by Streptococcus pneumoniae to recognize this organism's role in this disease.
Patient Report.—A 28-month-old, previously healthy white boy presented to the clinic with a 1-day history of fever, cold symptoms, and mild crankiness. He refused any oral intake during the morning of his presentation. His mother noted rapidly progressive swelling of the tongue during the 3 hours prior to the office visit. No history of tongue trauma, toxin