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Objective This paper reports a rare case of a 61-year-old man with sialodochitis fibrinosa. Methods Clinical case report and review of current literature. Results Sialodochitis fibrinosa is a diagnosis of exclusion and in many cases can be managed conservatively. Conservative management failed for this patient and he was managed successfully with staged bilateral total parotidectomy. Conclusion Sialodochitis fibrinosa should be considered as a differential diagnosis of painful bilateral facial swelling. While conservative management is successful for many patients, staged bilateral total parotidectomy may be necessary for full remission of symptoms; the timing of this is crucial to reduce the risk of facial nerve palsy.

Actinomyces are common commensals of the oral cavity, gastrointestinal tract and urogenital tract. They are anaerobic, Gram-positive, non-acid-fast bacilli, which can cause invasive infection and abscesses. We present the first reported case of supraglottitis and deep neck space abscess formation secondary to Actinomyces turicensis infection. The patient was managed with intravenous antibiotics, incision and drainage of a left parapharyngeal abscess and subsequent mediastinal abscess. After 6 weeks in hospital, the patient was successfully discharged to complete a 6-month course of oral amoxicillin.