喉頭蓋に生じた放線菌症例

Abstract

Actinomycosis is an inflammatory disease by the Actinomyces Sp. which is an anaerobic bacterium with a Gram-positive bacillus. The Actinomyces is an intraoral indigenous bacterium, and it is has been reported that actinomycosis often develops within the head and neck region, but reports on epiglottal actinomycosis are rare. We therefore report herein on one case of epiglottis actinomycosis which we experienced. A 49-year-old man was suffering from pharyngalgia. The patient apparently consulted a nearby otorhinolaryngologist for a diagnosis regarding the symptoms of a common cold. He was referred to our hospital, where on arrival he was found to have hoarseness, but without dyspnea. Laryngoscopy revealed significant swelling of the epiglottis and we judged that immediate hospitalization was necessary. After hospitalization, no change was seen in either the epiglottal swelling or the inflammatory reaction, and we first considered that a neoplastic change had occurred in the epiglottis following hospitalization. Having failed to reach a diagnosis following CT, MRI and PET/CT imaging, we performed a biopsy of the epiglottis under the general anesthesia. The result of the pathological examination revealed granulation tissue of the epiglottis caused by actinomycosis. We started oral treatment with AMPC(1500mg/day). The patient recovered on the 140th day after starting treatment. In the examination of any epiglottal tumor actinomycosis should be considered in the differential diagnosis.