Abstract

Actinomycosis (AM) is a rare, slowly progressive, chronic granulomatous inflammatory disease that can result in multiple abscesses, sinus tracts, tissue fibrosis, and fistula formation.1,2 It is caused by a group of Gram-positive, filamentous, anaerobic bacilli of the genus Actinomyces that are the endogenous microbiota of the mouth, gastrointestinal and genitourinary tracts.2 These microorganisms are usually commensal; Invasion of the subcutaneous plane therefore requires disruption of mucosal integrity and devitalized tissue. It usually spreads continuously to the adjacent soft tissues, bypassing the tissue plane and lymphatic drainage.3, 4 Cervicofacial AM is the most common presentation of the disease and dental infection or extraction and maxillofacial trauma are predisposing factors. It often develops as subacute or chronic soft tissue inflammation of the submandibular or paramandibular regions.3–6 The diagnosis of AM can easily be missed because it has a tendency to mimic a number of other conditions, including malignant and granulomatous diseases.4,7–9 Moreover, Actinomyces spp. Are very sensitive to a variety of antimicrobials, thus relatively low doses can render cultures negative.6 However, due to the fact that AM can be disfiguring or even fatal if vital structures including the airways and major vessels are involved, its correct diagnosis is of prime importance. In addition, it requires significantly longer treatment for its complete eradication

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