Invasive sinonasal actinomycosis: case report and literature review.

Nopawan Vorasubin, Arthur W Wu, Christina Day, Jeffrey D Suh

Journal: The Laryngoscope 2013;123(2):334-8

PMID: 23008010

Abstract

Actinomycosis is a rare anaerobic bacterial infection typically caused by Actinomyces israelii. Although part of normal flora in the oral cavity, and respiratory and digestive tracts, A israelii can give rise to pathologic infections most commonly reported in the oral cavity from odontogenic causes. We present a rare case of invasive actinomycosis presenting with extensive midface destruction involving the maxilla and paranasal sinuses, with mucosal necrosis mimicking an aggressive neoplasm. The diagnosis is usually reached only after histopathologic analysis showing characteristic sulfur granules with filamentous gram-positive, non-acid-fast bacteria. We review the literature on its epidemiology, clinical presentation, diagnosis, treatment, and prognosis.

Address: Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA. [email protected]

DOI: 10.1002/lary.23477

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MeSH Terms: Actinomycosis, Adjuvants, Pharmaceutic, Amoxicillin-Potassium Clavulanate Combination, Anti-Bacterial Agents, Diagnosis, Differential, Drug Therapy, Combination, Humans, Male, Middle Aged, Paranasal Sinus Diseases, Penicillin G, Positron-Emission Tomography, Probenecid, Tomography, X-Ray Computed