1887

Abstract

Introduction:

is a relatively uncommon cause of infection of the head and neck. However, its presentation is usually atypical and can be difficult to recognize. In this case report, we present the diagnostic and therapeutic challenges that can arise from cervicofacial actinomycosis.

Case presentation:

A 26-year-old woman from Northern Manitoba in her second trimester of pregnancy presented to the emergency department with a 2-month history of progressive pain and swelling of her right mandible. Imaging revealed lytic lesions involving the angle and ramus of the right mandible with possibility of osteosarcoma, and she was taken for hemimandibulectomy. Intraoperative specimens revealed . She was subsequently started on piperacillin–tazobactam that was later stepped down to amoxicillin–clavulanate with radiographic and clinical improvement of her osteomyelitis.

Conclusion:

Cervicofacial actinomycosis may mimic several neoplastic, granulomatous and infectious conditions, and often require tissue culture for diagnosis. Therapy often necessitates a combination of surgical resection and prolonged medical therapy, which is tailored to the burden of disease in the individual patient.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.005073
2016-11-01
2019-12-11
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/3/6/jmmcr005073.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.005073&mimeType=html&fmt=ahah

References

  1. Bartkowski S. B., Zapala J., Heczko P., Szuta M.. 1998; Actinomycotic osteomyelitis of the mandible: review of 15 cases. J Craniomaxillofac Surg26:63–67 [CrossRef][PubMed]
    [Google Scholar]
  2. Brook I.. 2008; Actinomycosis: diagnosis and management. South Med J101:1019–1023 [CrossRef][PubMed]
    [Google Scholar]
  3. Colmegna I., Rodriguez-Barradas M., Rauch R., Clarridge J., Young E. J.. 2003; Disseminated Actinomyces meyeri infection resembling lung cancer with brain metastases. Am J Med Sci326:152–155 [CrossRef][PubMed]
    [Google Scholar]
  4. Fu P. K., Tsai C. A.. 2010; Management of patients with huge pelvic actinomycosis complicated with hydronephrosis: a case report. J Microbiol Immunol Infect43:442–446 [CrossRef][PubMed]
    [Google Scholar]
  5. Gannepalli A., Ayinampudi B. K., Baghirath P. V., Reddy G. V.. 2015; Actinomycotic osteomyelitis of maxilla presenting as oroantral fistula: a rare case report. Case Rep Dent2015:689240 [CrossRef][PubMed]
    [Google Scholar]
  6. Hawnaur J. M., Reynolds K., McGettigan C.. 1999; Magnetic resonance imaging of actinomycosis presenting as pelvic malignancy. Br J Radiol72:1006–1011 [CrossRef][PubMed]
    [Google Scholar]
  7. Kubo M., Osada M., Konno S.. 1980; A histological and ultrastructural comparison of the sulfur granule of the actinomycosis and actinobacillosis. Natl Inst Anim Health Q (Tokyo)20:53–59
    [Google Scholar]
  8. Russo T. A.. 2015; Agents of actinomycosis. In Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases updated editionvol. 256 pp.2864–2873 Edited by Mandell G. L., Bennett J. E., Dolin R.. Philadelphia: Elsevier Saunders;
    [Google Scholar]
  9. Steininger C., Willinger B.. 2016; Resistance patterns in clinical isolates of pathogenic Actinomyces species. J Antimicrob Chemother71:422–427 [CrossRef][PubMed]
    [Google Scholar]
  10. Volante M., Contucci A. M., Fantoni M., Ricci R., Galli J.. 2005; Cervicofacial actinomycosis: still a difficult differential diagnosis. Acta Otorhinolaryngol Ital25:116–119[PubMed]
    [Google Scholar]
  11. Wong V. K., Turmezei T. D., Weston V. C.. 2011; Actinomycosis. BMJ343:d6099 [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.005073
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.005073
Loading

Data & Media loading...

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error