Intramuscular Compound Betamethasone for the Emergent Management of Lingual Angioedema

A 38-year-old male developed acute tongue swelling with slurred speech 2 hours after taking amoxicillin. On the basis of the patient's history, physical and oral examination, and laboratory findings, the diagnosis was confirmed as histamine-mediated lingual angioedema. Treatment included immediate discontinuation of amoxicillin, intramuscular injection of compound betamethasone, and oral levocetirizine. Tongue swelling resolved completely within 1 hour, with no recurrence at 3-day and 1-week follow-ups. The occurrence of histamine-mediated angioedema solely in the tongue is highly uncommon. Such swelling may progress to airway obstruction and asphyxia, becoming a life-threatening emergency, which requires prompt evaluation and management. Compound betamethasone offers rapid onset and sustained efficacy through a convenient intramuscular route, presenting distinct advantages for angioedema management. When combined with antihistamines, it may be a valuable option for acute emergencies encountered in oral practice.