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CASE REPORTS

Actinomycosis Causing Formation of Abcess and Fistula in The Mandibuler Region: A Case Report
Mandibulada Apse ve Fistül Traktı Oluşumuna Neden Olan Aktinomikoz: Bir Olgu Sunumu
Received Date : 23 Oct 2018
Accepted Date : 18 Jan 2019
Doi: 10.24179/kbbbbc.2018-61494 - Makale Dili: TR
KBB ve BBC Dergisi 2019;27(1):27-31
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Actinomycosis is a rare and slowly progressive disease caused by gram-positive, anaerobic bacillus actinomyces. Actinomyces may be pathogenic in the presence of some predisposing factors, although they are commensal microorganism in the oral flora. The most common form, cervicofacial actinomycosisis, might often be misdiagnosed as tumor or granulomatous infection with abcess formation, fistulous tracts, sulphur granules, or head and neck tissue fibrosis. Its treatment is high-dose penicillin. In this case report, we presented a patient with type 1 diabetes, malnutrion and poor oral hygiene, having a painless mass in mandibula with a hard fistula track and abcess formation in dental root, unresponsive to standart antibiotics for 10 months. After the pathologic diagnosis, high dose iv penicillin G was started. Our case, which is rare and, furthermore, difficult to diagnose and to treat, is discussed and reviewed within the context of current literature.
ÖZET
Aktinomikoz; gram-pozitif, anaerobik basil olan aktinomiçes türleri tarafından oluşturulan nadir görülen ve yavaş ilerleyen bir hastalıktır. Aktinomiçesler ağız florasında komensal bulunan bir mikroorganizma olsa da bazı predispozan faktörler varlığında patojen olabilmektedir. En sık görülen servikofasiyal aktinomikozda; baş-boyun bölgesinde apse odakları, fistül oluşumu, sülfür granülleri ve fibröz doku artışı ile karakterize ağrısız şişlikler tümör ve granülomatöz hastalıklarla sıkça karışabilmektedir. Tedavisi yüksek doz penisilindir. Bu çalışmada, mandibulada 10 aydır standart antibiyotik tedavilerine yanıt vermeyen sert fistül traktı içeren ağrısız kitle, diş kökünde apse ile kliniğimize başvuran tip 1 diyabetli, malnütrisyonlu, ağız hijyeni kötü olan olgunun sunulması amaçlanmıştır. Patolojik tanıdan sonra yüksek doz intravenöz penisilin G başlanmıştır. Nadir rastlanan, ayırıcı tanısı ve tedavisi zor olan olgumuz literatür gözden geçirilerek tartışılmıştır.
KAYNAKLAR
  1. Volante M, Contucci AM, Fantoni M, Ricci R, Galli J. Cervicofacial actinomycosis: still a difficult differential diagnosis. Acta Otorhinolaryngol Ital. 2005;25(2):116-9.
  2. Lancella A, Abbate G, Foscolo A, Dosdegani R. Two unusual presentations of cervicofacial actinomycosis and review of the literature. Acta Otorhinolaryngol Ital. 2008;28(2):89-93.
  3. McCann A, Alvi SA, Newman J, Kakarala K, Staecker H, Chiu A, et al. Atypical form of cervicofacial actinomycosis involving the skull base and temporal bone. Ann Otol Rhinol Laryngol. 2018;2018:3489418808541. [Crossref] 
  4. Chatterjee RP, Shah N, Kundu S, Mahmud SA, Bhandari S. Cervicofacial actinomycosis mimicking osseous neoplasm: a rare case. J Clin Diagn Res. 2015;9(7):ZD29-31. [Crossref] 
  5. Sharkawy AA, Chow AW (author), Calderwood SB (section editor), BloomA (deputy editor). Cervicofacial actinomycosis. UpToDate 2014. https://www.uptodate.com/contents/cervicofacial-actinomycosis.
  6. Ozcan C, Talas D, Gorur K, Aydin O, Yildiz A. Actinomycosis of the middle turbinate: an unusual cause of nasal obstruction. Eur Arch Otorhinolaryngol. 2005;262(5):412-5. [Crossref]  [PubMed] 
  7. Stewart AE, Palma JR, Amsberry JK. Cervicofacial actinomycosis. Otolaryngol Head Neck Surg. 2005;132(6):957-9. [Crossref]  [PubMed] 
  8. Smego RA Jr, Foglia G. Actinomycosis. Clin Infect Dis. 1998;26(6):1255-61. [Crossref] 
  9. Reichenbach J, Lopatin U, Mahlaoui N, Beovic B, Siler U, Zbinden R, et al. Actinomyces in chronic granulomatous disease: an emerging and unanticipated pathogen. Clin Infect Dis. 2009;49(11): 1703-10. [Crossref]  [PubMed]  [PMC] 
  10. Sasaki Y, Kaneda T, Uyeda JW, Okada H, Sekiya K, Suemitsu M, et al. Actinomycosis in the mandible: CT and MR findings. AJNR Am J Neuroradiol. 2014;35(2):390-4. [Crossref]  [PubMed] 
  11. Sudhakar SS, Ross JJ. Short-term treatment of actinomycosis: two cases and a review. Clin Infect Dis. 2004;38(4):444-7. [Crossref] 
  12. Ermis I, Topalan M, Aydin A, Erer M. Actinomycosis of the frontal and parotid regions. Ann Plast Surg. 2001;46(1):55-8. [Crossref]  [PubMed]