Actinomycosis arising from the nasal cavity, with rare fatal progression

Abstract

Actinomycosis is a common treatable disease caused byActinomyces, and generally has a good prognosis. However, we report a fatal case of actinomycosis of the nasal cavity. A 54-year-old man, reporting of left nasal obstruction, swelling and sharp pain around the root of the nose, was referred to our hospital. Histopathological examinations led to a definitive diagnosis of actinomycosis, and oral antibiotics were administered in an outpatient setting. However, the patient discontinued follow-up at the outpatient clinic because of the adverse effects of intravenous delivery, and poor compliance with oral antibiotic therapy led to him receiving a less than adequate dose. Thus, in the absence of sufficient antibiotic treatment, necrosis gradually progressed in the lesion, and the patient died of multiple organ failure and disseminated intravascular coagulation caused by local infection.

Actinomycosis of tongue: Rare presentation mimicking malignancy with literature review and imaging features

“…Cervicofacial actinomycosis can also affect organs such as lung, heart, and brain through blood stream from infected tissue. Although disseminated actinomycosis is uncommon but if occurs it may lead to multiorgan failure and death if left untreated [18] .…”

Actinomycosis of maxillary antrum presenting as nasal polypi: a rare case

“…Actinomyces israeli is the most common species to cause human infections, and belongs to the order Actinomycetales, a group intermediate between the true bacteria and the more complex fungi. [1][2][3][4][5][6] This fastidious bacteria has low pathogenicity. Thus infection occurs only in the presence of copathogens and following mucosal injury.…”

“…It presents as unilateral midfacial swelling over the side of the involved sinus. 1,5 Imaging frequently reveals unilateral sinus opacification accompanied by a soft tissue mass with focal calcifications and bony erosion due to the tendency for actinomycosis infections to spread through direct extension without regard for anatomical barriers. 1 Histologically the lesions consist of confluent nodules in the centre of which are colonies of the Actinomyces.…”

Brain abscess caused by chronic invasive actinomycosis in the nasopharynx

“…More than 30 species of pathogenic Actinomyces have been described, with Actinomyces israelii being the most common causative strain isolated from human specimens. [ 7 , 9 , 10 ] It can be difficult to diagnose actinomycosis, and incubation for at least 10 days in strictly anaerobic culture conditions is required for the isolation of Actinomyces species. [ 11 ] Macroscopically, large colonies of Actinomyces appear as yellow granules, termed as sulfur granules.…”

“…[ 3 , 6 ] The biological behavior of Actinomyces species ranges from chronic insidious growth, which is mainly represented by a painless indurated mass, to rapidly aggressive growth, which is characterized by invasion to the surrounding tissues and the formation of a painful pyogenic abscess. [ 3 , 7 , 8 ] We recently encountered a patient who developed an actinomycotic brain abscess 15 months after the treatment of chronic noninvasive nasopharyngeal actinomycosis, which recurred as an invasive form, and was successfully treated by surgical drainage of the abscess and antibiotic treatment. In this report, we describe the clinical course of this case and present a review of the relevant literature.…”