A year-old woman with a history of rheumatoid arthritis and on immunosuppressive agents presented with a two month history history of. This infection typically occurs following oral surgery or in patients with poor dental hygiene. Cervicofacial actinomycosis is characterized in the. BACKGROUND AND PURPOSE: Cervicofacial actinomycosis is uncommon, but without proper treatment it causes extensive tissue destruction. Early diagnosis.

Author: Nekasa Yozshulabar
Country: Yemen
Language: English (Spanish)
Genre: Relationship
Published (Last): 15 April 2005
Pages: 214
PDF File Size: 8.39 Mb
ePub File Size: 9.4 Mb
ISBN: 391-4-21751-179-8
Downloads: 83270
Price: Free* [*Free Regsitration Required]
Uploader: Gardazuru

Following personal experience in a case referred to our Department, and in agreement with reports in the literature, attention is drawn to the presenting clinical manifestations, stressing that these are often confusing since they mimic those of other diseases, Moreover, many pre-operative investigations radiological scans, incisional biopsy, fine-needle aspiration are generally non-specific.

The macroscopic presence of the classic sulfur granules in tissue specimens or drainage may be of some help when making diagnosis, even if these features are not pathognomic, since nocardiosis may also present with sulfur granules Current Infect Dis Reports.

Thus, microbiological identification of this organism is often impossible.

A history of orofacial trauma, dental manipulations, or infections is often elicited from these patients. A firm, indurated mass, on or near the mandible with associated abscess formation or draining sinus tract, is cericofacial typical physical finding in this disease. Thus, dental caries, dental manipulations and oromaxillofacial traumas are the most common triggering events 1 4 — 9.

Cervicofacial Actinomycosis

The symptom temporarily responded to short courses of antibiotics, actinomycosus progressively worsened over time. Paludetti G, Rosignoli M. Abscess with sulfur granules with organisms consistent with Actinomyces species. Ear Nose Throat J ; Ann Otol Rhinol Laryngol ; Get free access to newly published articles. In cervicofacial actinomycosis, which is the most frequent manifestation, infection is frequently the result of oromaxillofacial trauma, dental manipulation or dental caries Smith AJ, et al.


Cervicofacial actinomycosis: still a difficult differential diagnosis

Enferm Infecc Actinomycsis Clin ; Antibiotic therapy, previously prescribed by a physician, did not lead to a decrease in size of the mass. A haematic-caseous discharge from the lower fluctuant portion of the mass was collected through a percutaneous incision.

Received Nov 19; Accepted Jan 3. A comparison between clinical and microbiologic findings avoids serious errors in the differential diagnosis. Support Center Support Center. Sulfur granules, when present, are diagnostic.

Cervicofacial Actinomycosis: Diagnosis and Management.

Introduction Actinomycosis is a suppurative and granulomatous chronic infectious disease, that usually spreads into adjacent soft tissues without regard for tissue planes or lymphatic drainage; it may also be associated with a draining sinus tract 1 — 3.

Also in the present case, CT was found to be useful in planning the surgical treatment 20 Pathologic quiz case 1. HE stain high-power field: J Formosan Med Assoc. Ann Intern Med ; In conclusion, although it is a rare infectious cervicofacial disease, actinomycosis of the head and neck represents, among neck masses, an interesting disease, on account of the difficulties involved in the diagnosis. The first of these manifestations is the most frequent, although fairly uncommon: Susceptibility of Actinomyces israelii to antibiotics, sodium hypochlorite and calcium hydroxide.


Br J Oral Surg ; Sign in to make a comment Sign in to your personal account.

Atypical presentations of actinomycosis. Please review our privacy policy. Routine blood tests were normal and PPD was placed which was found to be nonreactive and there was no response to PPD.

Cervicofacial Actinomycosis: Diagnosis and Management.

National Center for Biotechnology InformationU. Stewart MG, Sulek M. More commonly, the diagnosis is made via culture or biopsy. J Gen Intern Med. CT diagnosis of actinomycosis of the neck. Antimicrobial susceptibility testing of Actinomyces species with 12 antimicrobial agents. Grzegorz Barszczewski cervlcofacial. Even if surgery plays an important role both in the diagnosis and treatment of actinomycosis, recurrence following surgery alone is very common, and weeks of high-dose intravenous antibiotics are a fundamental part of treatment, followed by months of oral antibiotics.

Reviewers All Reviewers Several Authors agree that incisional biopsy can be of great help in the diagnosis of actinomycosis, since microscopic examination reveals a typical finding of an outer zone of granulation and a central zone of necrosis which contains multiple basophilic granules, that represent lobulated micro-colonies of Actinomyces 5. Initially, the mass may be surrounded by induration or erythema; later, it may become tender to palpation, on account of a central necrosis process actiinomycosis