Nasopharyngeal Actinomycosis

Abstract

Nasopharyngeal actinomycosis is a rarely encountered bacterial infection which usually occurs after nasal trauma or surgery. In some clinical cases, nasopharyngeal actinomycosis has appeared in patients without prior trauma, making diagnosis difficult. Here we present three such cases successfully treated with appropriate dosages of penicillin. One 16-year-old boy with no previous medical antecedents showed an important thickening of the posterior wall of the nasopharynx. A similar nasopharyngeal thickening was found in a 42-year-old woman exhibiting poor dental hygiene. In another 42-year-old woman, nasopharyngeal inflammation was accompanied by multiple right lymphoadenopathies. Like the first two patients, the woman had no prior trauma but did exhibit poor dental hygiene and teeth rottenness. In all three patients, actinomycosis diagnosis was confirmed by anaerobic microbial culturing of the biopsy specimen. Although diagnosis is delayed in patients with no prior trauma, treatment with antibiotics has greatly improved the prognosis for all forms of actinomycosis, and neither death nor deformity is common.

A Case of Actinomycosis in the Rosenmüller’s Fossa

“…Studies on actinomycosis in the nasopharynx are extremely rare, and most reported cases occurred in the posterior wall. 2-10 This report presents a case of actinomycosis in the Rosenmüller’s fossa.…”

Actinomyces europaeusIsolated from a Breast Abscess in a Penicillin-Allergic Patient

“…Actinomyces species are normal commensal bacteria that can be found in the oral cavity and the lower reproductive tract of women [ 1 ]. The bacteria are Gram-positive, filamentous, non-acid-fast, and anaerobic-to-microaerophilic [ 2 ]. This species is pathogenic but nonvirulent, so infection is often opportunistic leading to actinomycosis which is a rare subacute-to-chronic infection [ 3 ].…”

“…This species is pathogenic but nonvirulent, so infection is often opportunistic leading to actinomycosis which is a rare subacute-to-chronic infection [ 3 ]. Actinomycosis is characterised by localised spread via abscess and sinus tracts with granulomatous inflammation [ 2 ]. Due to this propensity for local spread, identified infections should be investigated for deep sources which may contribute to an ongoing insidious clinical source or may be mistaken for other pathologies such as carcinomas [ 4 ].…”

Multiple Lower Cranial Nerve Palsies Due to Nasopharyngeal Actinomycosis Masquerading as a Tumour – A Diagnostic Conundrum

“…Actinomyces, the causative organism, is a gram-positive, branching and filamentous bacterium. [ 3 ] It is often a commensal inhabiting oropharynx, gastrointestinal and urogenital tract. [ 4 ] Healthy people usually get infected after a mucosal trauma or inoculation into an anaerobic environment.…”

“…There was a decrease in the incidence of actinomycosis after the introduction of broad-range antibiotics and maintaining good oral hygiene. [ 3 ] In late presentation or delay in diagnosis, they can present as an invasive lesion with surrounding tissue destruction. These can mimic either as a malignant lesion or chronic infective lesions like tuberculosis or fungal infection.…”