Cervicofacial Primary Cutaneous Actinomycosis

Jeong, Yeon Jin; Suh, Hyo Wan; Shim, Hyung-Sup

doi:10.1097/scs.0000000000003518

Journal of Craniofacial Surgery

2017

DOI: 10.1097/scs.0000000000003518

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Cervicofacial Primary Cutaneous Actinomycosis

Yeon Jin Jeong

Hyo Wan Suh²,

Hyung-Sup Shim³

Abstract: Actinomycosis, an infectious bacterial disease caused by Actinomyces species, is very rare and is characterized by contiguous spreading, subacute to chronic granulomatous inflammation and the formation of multiple abscesses and sinus tracts that may discharge sulfur granules. Actinomycosis that presents on the skin without endogenous origin is called primary cutaneous actinomycosis, and the occurrence and treatment of primary cutaneous actinomycosis is rarely reported. This report describes the treatment of pr… Show more

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Cited by 4 publications

References 9 publications

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Clinical features of actinomycosis: A 20-year experience of a single institute in Southern China

Zhang

et al. 2021

Journal of Medical Mycology

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BackgroundActinomycosis is a rare indolent infectious disease with nonspecific clinical presentations that delay diagnosis. Although actinomycosis is thought to be more prevalent in developing countries, data from developing countries are scanty. This study was to reveal the current situation of actinomycosis in developing countries and the difference from that in developed countries. MethodsPatients fulfilling the inclusion criteria for actinomycosis from Nanfang Hospital in southern China

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Clinical features of actinomycosis: A 20-year experience of a single institute in Southern China

Zhang

et al. 2021

Journal of Medical Mycology

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Periapical Actinomycosis: A Rare Subdivision of Cervicofacial Actinomycosis, Review of the Literature, and a Case Report

Dastgir

Sohrabi

2022

Case Reports in Dentistry

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Background. Periapical actinomycosis, which is reckoned as a subgroup of cervicofacial actinomycosis, is an uncommon, more indolent, less invasive, and limited type of actinomycosis infection. However, it can be considerably underreported due to the low number of periapical surgical specimens that are submitted for histopathological analysis after excision of the lesion with the preliminary diagnosis of typical periapical infections. It is believed that during root canal treatment, the organisms are displaced from the oral cavity into the periapical regions as a result of failure to establish aseptic techniques which can further result in actinomycosis infections and, in rare instances, lead to more severe events and can even be life-threatening. Case Presentation. We intend to report a case of periapical actinomycosis in a 34-year-old female who presented with the chief complaint of pain and slight mobility of the mandibular right second premolar and first molar with no significant issues in the patient’s medical history. Initial orthopantomography revealed a uniloculated, radiolucent lesion engulfing the apices of the aforementioned teeth. An incisional biopsy was then obtained which revealed fragments of fibroconnective tissue including few crushed bone particles severely infiltrated by acute inflammatory cells and some foamy macrophages. The suppurative exudate focally surrounds colonies of filamentous bacteria as round basophilic masses with radial configuration resembling “sulfur granules.” Surgical approach consisted of curettage accompanied with peripheral ostectomy and cautious burnishing of the two involved tooth roots. Conclusion. This case report emphasizes the importance of aseptic techniques during endodontic and more invasive treatments, as they can cause penetration of Actinomyces into the periapical region which in some cases can lead to more serious complications and even life-threatening situations.

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Atypical Form of Cervicofacial Actinomycosis Involving the Skull Base and Temporal Bone

McCann

Alvi

Newman

et al. 2018

Ann Otol Rhinol Laryngol

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Background: Cervicofacial actinomycosis is an uncommon indolent infection caused by Actinomyces spp that typically affects individuals with innate or adaptive immunodeficiencies. Soft tissues of the face and neck are most commonly involved. Actinomyces osteomyelitis is uncommon; involvement of the skull base and temporal bone is exceedingly rare. The authors present a unique case of refractory cervicofacial actinomycosis with development of skull base and temporal bone osteomyelitis in an otherwise healthy individual. Methods: Case report with literature review. Results: A 69-year-old man presented with a soft tissue infection, culture positive for Actinomyces, over the right maxilla. Previous unsuccessful treatment included local debridement and 6 weeks of intravenous ceftriaxone. He was subsequently treated with conservative debridement and a prolonged course of intravenous followed by oral antibiotic. However, he eventually required multiple procedures, including maxillectomy, pterygopalatine fossa debridement, and a radical mastoidectomy to clear his disease. Postoperatively he was gradually transitioned off intravenous antibiotics. Conclusions: Cervicofacial actinomycosis involves soft tissue surrounding the facial skeleton and oral cavity and is typically associated with a history of mucosal trauma, surgery, or immunodeficiency. The patient was appropriately treated but experienced disease progression and escalation of therapy. Although actinomycosis is typically not an aggressive bacterial infection, this case illustrates the need for prompt recognition of persistent disease and earlier surgical intervention in cases of recalcitrant cervicofacial actinomycosis. Chronic actinomycosis has the potential for significant morbidity.

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Cervicofacial Primary Cutaneous Actinomycosis

Cited by 4 publications

References 9 publications

Clinical features of actinomycosis: A 20-year experience of a single institute in Southern China

Clinical features of actinomycosis: A 20-year experience of a single institute in Southern China

Periapical Actinomycosis: A Rare Subdivision of Cervicofacial Actinomycosis, Review of the Literature, and a Case Report

Atypical Form of Cervicofacial Actinomycosis Involving the Skull Base and Temporal Bone

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