A year-old woman with a history of rheumatoid arthritis and on immunosuppressive agents presented with a two month history history of. This infection typically occurs following oral surgery or in patients with poor dental hygiene. Cervicofacial actinomycosis is characterized in the. BACKGROUND AND PURPOSE: Cervicofacial actinomycosis is uncommon, but without proper treatment it causes extensive tissue destruction. Early diagnosis.

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In the acute phase of treatment, penicillin can be replaced by cephalosporins which are also effective if a co-infection with other bacteria not responding to penicillin causes the persistence of symptoms due to Actinomyces 30 — Cervicofacial actinomycosis requires surgical treatment, oral cavity sanation, and in the case of presenting actinomycosis abscesses formation, combined surgical incision and drainage.

Finally, actinomgcosis excision of the mass is now the last essential step to make a definitive diagnosis and define the appropriate antibiotic therapy. The patient made a complete recovery and, moreover, follow-up revealed no recurrence of the infection. This article has been cited by other articles in PMC. Rapid diagnosis of actinomycosis by thin-needle aspiration biopsy.

Actinomyces Israelii is a gram-positive micro organism with worldwide distribution.

Cervicofacial actinomycosis following jaw pathology – Case Reports

Antimicrobial susceptibility testing of Actinomyces species with 12 antimicrobial agents. Furthermore, imaging techniques computed tomo-graphy CT and magnetic resonance imaging MRI scan usually yield non-specific findings, contributing only to define radiological features of the mass and its involvement in adjacent soft tissues.

A haematic-caseous discharge from the lower fluctuant portion of the mass was collected through a percutaneous incision. Introduction Actinomycosis is a suppurative and granulomatous chronic infectious disease, that usually spreads into adjacent soft tissues without regard for tissue planes or lymphatic drainage; it may also be associated with a draining sinus tract 1 — 3.


A year-old woman with a history of rheumatoid arthritis and on immunosuppressive agents presented with a two month history history of slowly progressive right facial swelling with recurrent eruptions.

Actinomycosis of the neck: Arch Intern Med ; Reviewers All Reviewers Presentation of five cases. Oral and cervicofacial actinomycosis. Initially, the mass may be surrounded by induration or erythema; later, it may become tender to palpation, on account of a central cervicofaciwl process 17 Microscopic findings of chronic inflammation with the presence of multiple granules surrounded by polymorphocytes were consistent with diagnosis of actinomycosis haematoxylin and eosin stain; magnification X Thus, microbiological identification of actinmoycosis organism is often impossible.

A central neutrophilic, lobulated abscess with round basophilic masses arrowheadand thin basophilic radiating filaments at the periphery arrows. A history of orofacial trauma, dental manipulations, or infections is often elicited from these patients. The symptom temporarily responded to short courses of antibiotics, but progressively worsened over time.

The condition is considered an important clinical entity, on account not only of the difficulties involved in the diagnosis but also the long-term treatment necessary to eradicate the disease 10 — Cervicofacial actinomycosis following orthognathic surgery: J Oral Maxillofac Surg ; Successful treatment of thoracic actinomycosis with ceftriaxone.

Cervicofacial Actinomycosis: Diagnosis and Management.

CT diagnosis of actinomycosis of the neck. Antibiotic therapy, previously prescribed by a physician, did not lead to a decrease in size of the mass. Miller M, Haddad AJ.

Open in a separate window. In conclusion, although it is a rare infectious cervicofacial disease, actinomycosis of the head and neck represents, among neck masses, an interesting disease, on account of the difficulties involved in the diagnosis.


A specimen submitted to microbiologic culture revealed the presence of Fresobacterium Nucleatum, Porphyromonas Asaccharolytica and Staphylococcus Aureus. Japan Find articles by Masatomi Ikusaka. CT findings in six patients. Volante M, et al.

Cervicofacial Actinomycosis: Diagnosis and Management.

Su di un caso di actinomicosi cervico-facciale cervicofaccial da grave emorragia. Actinomyces are Gram-positive, non-acid fast, anaerobic or microaerophilic filamentous branched bacteria, living as commensal organisms in the human oral cavity and respiratory and digestive tracts, becoming invasive when, through a mucosal lesion, they gain access to the subcutaneous tissue. Japan Find articles by Toshihiko Takada. Self-destruction of abscesses and formation of fistulae are observed in chronic stages.

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Actinomycosis of the face and neck. Treatment includes prolonged courses of antibiotics and often surgery. In cervicofacial actinomycosis, which is the most frequent manifestation, infection is frequently the result of oromaxillofacial trauma, dental manipulation or dental caries Several Authors agree that incisional biopsy can be of great help in the diagnosis of actinomycosis, since microscopic examination reveals a typical finding of an outer zone of granulation and a central zone of necrosis which contains multiple basophilic granules, that represent lobulated micro-colonies of Actinomyces 5.

Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. Biopsies from the abscess wall or sinus tract, when positive, eliminate the two-to-three-week culture period.