Actinomycosis in head and neck region of pediatric patients: a review

Abstract

The majority of cases of actinomycosis are of odontogenic origin and related to the perimandibular region with other sites of primary actinomycosis in the head and neck region include the tongue, paranasal sinuses, middle ear, larynx, lacrimal passage, and thyroid gland. Actinomycosis is an uncommon infection caused by Actinomyces species, facultative anaerobic bacteria that are part of the normal flora in the oropharynx, gastrointestinal tract, and female genital tract. The risk factors for actinomycosis in the pediatric age group are dental caries, trauma, debilitation, and poorly controlled diabetes mellitus. The pathogenesis of the actinomycosis in the head and neck region is often unclear. The hallmark of actinomycosis is the spread of infection which fails to respect the tissue or fascial planes. The organism causing actinomycosis is often difficult to isolate from culture and the differential diagnosis is extensive which prompts clinicians to name the actinomycosis the masquerader of the head and neck area. This clinical entity in pediatric patients may mimic malignancy or granulomatous disease in the head and neck region. Clinicians must be aware of typical presentations of actinomycosis in the head and neck region. Bacterial cultures and histopathological study are the cornerstones of the diagnosis of actinomycosis, however, particular conditions are needed to find the exact diagnosis. The treatment of actinomycosis includes a combination of surgery and antibiotic therapy. Surgery is an important adjunctive to medical therapy in patients with extensive lesions of actinomycosis. Actinomyces species are uniformly susceptible to penicillin. This review article discusses the etiopathology, epidemiology, clinical manifestations, diagnosis, and current treatment of the actinomycosis in the head and neck region of pediatric patients.