Atypical presentations of actinomycosis

Michael J. Belmont, Philomena M. Behar, Mark Wax

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Background. Actinomycotic infections of the cervicofacial region are uncommon. Most major medical centers report approximately one case per year. Presenting clinical manifestations are confusing because they often mimic other disease processes. Diagnosis may be difficult due to a general lack of familiarity with the disease and the fastidious nature of the organism in culture. The cervicofacial manifestations of actinomycosis are varied, and a high index of suspicion is required to make an accurate and timely diagnosis. Methods. Retrospective chart review with the presentation of four unusual cases of actinomycosis were performed. Results. Two patients were initially seen with dysphagia from a tongue base mass. The third patient was initially seen with a 3-week history of worsening hoarseness and stridor. Examination revealed an ulcerative lesion of the left hemilarynx and pyriform sinus. All three patients were thought to have a neoplastic process. Diagnosis was made on histologic examination of a tissue biopsy. The fourth patient was initially seen with a buccal space mass that was draining externally. Culture of the purulent drainage revealed Actinomyces. In all four cases, symptoms resolved after appropriate antimicrobial therapy. Conclusions. Actinomycosis of the head and neck, although rare, is an important entity to the otolaryngologist. A confusing clinical presentation combined with the fastidious nature of the organism make for a difficult diagnosis. A high index of suspicion is required to make an accurate diagnosis and institute the appropriate antibiotic therapy.

Original languageEnglish (US)
Pages (from-to)264-268
Number of pages5
JournalHead and Neck
Volume21
Issue number3
DOIs
StatePublished - May 1999

Fingerprint

Actinomycosis
Cervicofacial Actinomycosis
Pyriform Sinus
Neoplastic Processes
Actinomyces
Hoarseness
Cheek
Respiratory Sounds
Deglutition Disorders
Tongue
Drainage
Neck
Head
Anti-Bacterial Agents
Biopsy
Therapeutics
Infection

Keywords

  • Actinomycosis
  • Buccal space
  • Cervicofacial
  • Larynx
  • Tongue

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Atypical presentations of actinomycosis. / Belmont, Michael J.; Behar, Philomena M.; Wax, Mark.

In: Head and Neck, Vol. 21, No. 3, 05.1999, p. 264-268.

Research output: Contribution to journalArticle

Belmont, Michael J. ; Behar, Philomena M. ; Wax, Mark. / Atypical presentations of actinomycosis. In: Head and Neck. 1999 ; Vol. 21, No. 3. pp. 264-268.
@article{c017bb5e2e4641619a610a7919ce8b01,
title = "Atypical presentations of actinomycosis",
abstract = "Background. Actinomycotic infections of the cervicofacial region are uncommon. Most major medical centers report approximately one case per year. Presenting clinical manifestations are confusing because they often mimic other disease processes. Diagnosis may be difficult due to a general lack of familiarity with the disease and the fastidious nature of the organism in culture. The cervicofacial manifestations of actinomycosis are varied, and a high index of suspicion is required to make an accurate and timely diagnosis. Methods. Retrospective chart review with the presentation of four unusual cases of actinomycosis were performed. Results. Two patients were initially seen with dysphagia from a tongue base mass. The third patient was initially seen with a 3-week history of worsening hoarseness and stridor. Examination revealed an ulcerative lesion of the left hemilarynx and pyriform sinus. All three patients were thought to have a neoplastic process. Diagnosis was made on histologic examination of a tissue biopsy. The fourth patient was initially seen with a buccal space mass that was draining externally. Culture of the purulent drainage revealed Actinomyces. In all four cases, symptoms resolved after appropriate antimicrobial therapy. Conclusions. Actinomycosis of the head and neck, although rare, is an important entity to the otolaryngologist. A confusing clinical presentation combined with the fastidious nature of the organism make for a difficult diagnosis. A high index of suspicion is required to make an accurate diagnosis and institute the appropriate antibiotic therapy.",
keywords = "Actinomycosis, Buccal space, Cervicofacial, Larynx, Tongue",
author = "Belmont, {Michael J.} and Behar, {Philomena M.} and Mark Wax",
year = "1999",
month = "5",
doi = "10.1002/(SICI)1097-0347(199905)21:3<264::AID-HED12>3.0.CO;2-Y",
language = "English (US)",
volume = "21",
pages = "264--268",
journal = "Head and Neck",
issn = "1043-3074",
publisher = "Wiley-Liss Inc.",
number = "3",

}

TY - JOUR

T1 - Atypical presentations of actinomycosis

AU - Belmont, Michael J.

AU - Behar, Philomena M.

AU - Wax, Mark

PY - 1999/5

Y1 - 1999/5

N2 - Background. Actinomycotic infections of the cervicofacial region are uncommon. Most major medical centers report approximately one case per year. Presenting clinical manifestations are confusing because they often mimic other disease processes. Diagnosis may be difficult due to a general lack of familiarity with the disease and the fastidious nature of the organism in culture. The cervicofacial manifestations of actinomycosis are varied, and a high index of suspicion is required to make an accurate and timely diagnosis. Methods. Retrospective chart review with the presentation of four unusual cases of actinomycosis were performed. Results. Two patients were initially seen with dysphagia from a tongue base mass. The third patient was initially seen with a 3-week history of worsening hoarseness and stridor. Examination revealed an ulcerative lesion of the left hemilarynx and pyriform sinus. All three patients were thought to have a neoplastic process. Diagnosis was made on histologic examination of a tissue biopsy. The fourth patient was initially seen with a buccal space mass that was draining externally. Culture of the purulent drainage revealed Actinomyces. In all four cases, symptoms resolved after appropriate antimicrobial therapy. Conclusions. Actinomycosis of the head and neck, although rare, is an important entity to the otolaryngologist. A confusing clinical presentation combined with the fastidious nature of the organism make for a difficult diagnosis. A high index of suspicion is required to make an accurate diagnosis and institute the appropriate antibiotic therapy.

AB - Background. Actinomycotic infections of the cervicofacial region are uncommon. Most major medical centers report approximately one case per year. Presenting clinical manifestations are confusing because they often mimic other disease processes. Diagnosis may be difficult due to a general lack of familiarity with the disease and the fastidious nature of the organism in culture. The cervicofacial manifestations of actinomycosis are varied, and a high index of suspicion is required to make an accurate and timely diagnosis. Methods. Retrospective chart review with the presentation of four unusual cases of actinomycosis were performed. Results. Two patients were initially seen with dysphagia from a tongue base mass. The third patient was initially seen with a 3-week history of worsening hoarseness and stridor. Examination revealed an ulcerative lesion of the left hemilarynx and pyriform sinus. All three patients were thought to have a neoplastic process. Diagnosis was made on histologic examination of a tissue biopsy. The fourth patient was initially seen with a buccal space mass that was draining externally. Culture of the purulent drainage revealed Actinomyces. In all four cases, symptoms resolved after appropriate antimicrobial therapy. Conclusions. Actinomycosis of the head and neck, although rare, is an important entity to the otolaryngologist. A confusing clinical presentation combined with the fastidious nature of the organism make for a difficult diagnosis. A high index of suspicion is required to make an accurate diagnosis and institute the appropriate antibiotic therapy.

KW - Actinomycosis

KW - Buccal space

KW - Cervicofacial

KW - Larynx

KW - Tongue

UR - http://www.scopus.com/inward/record.url?scp=0032963276&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032963276&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1097-0347(199905)21:3<264::AID-HED12>3.0.CO;2-Y

DO - 10.1002/(SICI)1097-0347(199905)21:3<264::AID-HED12>3.0.CO;2-Y

M3 - Article

C2 - 10208670

AN - SCOPUS:0032963276

VL - 21

SP - 264

EP - 268

JO - Head and Neck

JF - Head and Neck

SN - 1043-3074

IS - 3

ER -