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| Cervicofacial actinomycosis |
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| Abdominal actinomycosis |
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Introduction
Cervicofacial actinomycosis is a chronic infection of the head and neck, occurring most often in adult males and caused by bacteria of the genus Actinomyces.
Aetiology of cervicofacial actinomycosis
Actinomyces spp. are part of the normal flora of the oropharynx. The most common pathogen is Actinomyces israelii, a Gram-positive anaerobe with a filamentous branching growth pattern. However, other actinomycetes have been implicated and furthermore many actinomycotic lesions contain ‘companion’ bacteria, including Actinobacillus spp., Prevotella spp. and Fusobacterium spp.
Risk factors for cervicofacial actinomycosis include:
- Tooth decay
- Dental operations
- Maxillofacial trauma.
Diagnosis of cervicofacial actinomycosis
Clinical
- Early signs include a small, flat hard swelling in the mouth or on the neck or jaw (subperiosteal).
- Many small, communicating abscesses then appear, with surrounding granulation and sinuses that discharge sulphur-like granules containing the organism.
- Actinomycosis may be seen in the tonsils, tongue, cheek or lips where it is usually implanted by trauma.
- Complications include spread to the brain, and to nearby bones and soft tissues. Pulmonary and abdominal infections are also occasionally seen
Cervicofacial actinomycosis: sulphur granules
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