Actinomycosis in head-and-neck region – A review

Abstract

Actinomycosis is an uncommon chronic disease caused by filamentous Actinomyces, a Gram-positive anaerobic bacterium that usually colonizes in the human oral cavity, digestive tract, and genital area. Actinomycosis is rarely seen chronic infectious disease in the head-and-neck region. The clinical presentations are often nonspecific and mimic several diseases of the head-and-neck area such as malignancy and tuberculosis. Moreover, investigations such as imaging, fine-needle aspiration, and biopsy are often nonspecific. The diagnosis of actinomycosis is still difficult for the diagnosis at present time. Bacterial culture and histopathological study are the cornerstones of the diagnosis but a particular situation is needed to get the exact diagnosis. The prolonged bacterial cultures in anaerobic conditions are required to confirm the bacterium and classical microscopic findings like necrosis with yellowish sulfur granules and filamentous Gram-positive fungal-like pathogens. The surgical excision of the lesion/mass along with appropriate antibiotic therapy is important treatment options. Clinicians must be aware of the typical clinical presentations of actinomycosis in the head-and-neck region as it may mimic the malignant process in the head-and-neck area. Actinomycosis patients need prolonged high doses of penicillin G or amoxicillin and the period of antimicrobial treatment can be shortened to a minimum of 3 months in patients in whom optimum surgical resection of the infected tissues has been useful.