Actinomycosis of the post-cricoid space: an unusual cause of dysphagia

Abstract

Cervicofacial actinomycosis is known to affect many soft tissues and bony structures in the head and neck. However to the authors' knowledge, actinomycosis of the post-cricoid region has not been previously reported. A case of a 74-year-old male who developed actinomycosis of the post-cricoid region after radiotherapy for a laryngeal carcinoma is presented. Actinomycosis should be considered in the differential diagnosis of dysphagia following radiotherapy for squamous cell carcinoma of the larynx, as early treatment is likely to result in a favourable outcome.

Laryngeal Actinomycosis: A Case Report and Systematic Review of 32 Cases in the Literature

“…Our case and analysis of similar cases shows that primary infection of the larynx restricted only to the glottis or its substructures, has been successfully treated and suppressed with excision of the lesion and eight weeks of oral penicillin based therapy [10,12,13,21]. More involved lesions, such as those with concurrent pulmonary involvement require more invasive therapy, including a course of intravenous antibiotic therapy.…”

“…No cases reported seeding of disease to new site when the primary lesion was restricted only to the larynx. Cases with involvement limited to the larynx were treated with a shorter term dose of oral only antibiotics: 500-625 mg oral penicillin based therapy three times a day for up to 8 weeks following excisional biopsy [10,12,13,21].…”

Vocal Cord Actinomycosis Mimicking a Laryngeal Tumor

“…Actinomyces israelii is a commensal saprophyte of the normal oral flora [1–4]. Trauma, for example, tooth extraction, caries, and dental manipulation, causes disruption of the normal mucosa and predisposes to infection.…”

Actinomycosis of the larynx

“…Most forms of Actinomycetes are true anaerobic, microaerophilic, non-acid-fast branched filamentous, non-sporeforming bacilli that can be found in the mouth and pharynx as normal commensals [5]. While Actinomyces israelii remains the most common pathogen, Actinomyces naeslundii, Actinomyces viscosis, Actinomyces propionica, and Actinomyces odontolyticus may also present as a variety of infectious disease entities [6].…”