Actinomycosis of the Frontal and Parotid Regions

Abstract

Cervicofacial actinomycosis still occurs infrequently and should be included in the differential diagnosis of neoplasms, and chronic suppurative and granulomatous lesions of the head and neck region. The authors present two cases of actinomycosis. Patient 1 was a 32-year-old man who was first seen with a firm, suppurative mass at his left frontal region. Patient 2 was a 36-year-old woman with an indurated mass at her left parotid area. Both patients were diagnosed histopathologically with cervicofacial actinomycosis, but each patient had a different clinical course and different response to antimicrobial and surgical treatments.

Treatment of cervicofacial Actinomycosis: A report of 19 cases and review of literature

“…Actinomycosis can present as a chronic, slowly progressive infiltration, or as a more acute and rapidly progressive swelling (24). In accordance with the literature (7,13,14,16,17,21,22,25) our patients presented with persistent, sometimes recurrent swellings, which were both tender and non-tender, and non-responsive to short-term oral antibiotics. Most studies describe a latency of infection ranging from a few weeks to over one year (12,14-17,20-23,26), whereas most of our patients presented within one week of start of symptoms.…”

“…The majority of our patients received antibiotic treatment for a duration of 1 – 4 weeks, being shorter than the 3 – 52 weeks reported in the literature (12-14,16-22). Perhaps this is because our patients were treated with a combination of penicillin and metronidazol, affecting a larger microbial spectrum, and making the environment unfavourable for Actinomyces.…”

“…Thus, the paediatric patients were excluded. Different departments were involved in the treatment of these patients, including the department of otolaryngology head and neck surgery (12,16,19,20,23), dermatology (13), internal medicine (17), Microbioloby (18) plastic and reconstructive surgery (14), radiology (21), and maxillofacial surgery (13,18,22). Table 2 shows an overview of the treatment modality, treatment duration, and patient outcome retrieved in these 12 publications.…”

Actinomycosis of the parotid masquerading as malignant neoplasm.

“…The commonest cause of a painless progressive swelling in the parotid region is the parotid neoplasms, the other causes being very rare (Table 1) [4-6]. A diagnosis can very often be made by clinical and radiological features followed by a fine needle aspiration cytology (FNAC).…”

Rare Non-Tumor Diseases of the Pharynx and Larynx

“…Клинически и рентгенологи-чески у таких пациентов часто предполагается опухолевый процесс, гранулематозное воспа-ление, туберкулезная или грибковая инфекция [23]. В большинстве случаев диагноз ставится только по результатам биопсии [24,25].…”