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1/16. Atypical presentations of actinomycosis.

    BACKGROUND: Actinomycotic infections of the cervicofacial region are uncommon. Most major medical centers report approximately one case per year. Presenting clinical manifestations are confusing because they often mimic other disease processes. diagnosis may be difficult due to a general lack of familiarity with the disease and the fastidious nature of the organism in culture. The cervicofacial manifestations of actinomycosis are varied, and a high index of suspicion is required to make an accurate and timely diagnosis. methods: Retrospective chart review with the presentation of four unusual cases of actinomycosis were performed. RESULTS: Two patients were initially seen with dysphagia from a tongue base mass. The third patient was initially seen with a 3-week history of worsening hoarseness and stridor. Examination revealed an ulcerative lesion of the left hemilarynx and pyriform sinus. All three patients were thought to have a neoplastic process. diagnosis was made on histologic examination of a tissue biopsy. The fourth patient was initially seen with a buccal space mass that was draining externally. culture of the purulent drainage revealed actinomyces. In all four cases, symptoms resolved after appropriate antimicrobial therapy. CONCLUSIONS: actinomycosis of the head and neck, although rare, is an important entity to the otolaryngologist. A confusing clinical presentation combined with the fastidious nature of the organism make for a difficult diagnosis. A high index of suspicion is required to make an accurate diagnosis and institute the appropriate antibiotic therapy.
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keywords = neck
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2/16. actinomycosis of the frontal and parotid regions.

    Cervicofacial actinomycosis still occurs infrequently and should be included in the differential diagnosis of neoplasms, and chronic suppurative and granulomatous lesions of the head and neck region. The authors present two cases of actinomycosis. Patient 1 was a 32-year-old man who was first seen with a firm, suppurative mass at his left frontal region. Patient 2 was a 36-year-old woman with an indurated mass at her left parotid area. Both patients were diagnosed histopathologically with cervicofacial actinomycosis, but each patient had a different clinical course and different response to antimicrobial and surgical treatments.
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3/16. actinomycosis of the post-cricoid space: an unusual cause of dysphagia.

    Cervicofacial actinomycosis is known to affect many soft tissues and bony structures in the head and neck. However to the authors' knowledge, actinomycosis of the post-cricoid region has not been previously reported. A case of a 74-year-old male who developed actinomycosis of the post-cricoid region after radiotherapy for a laryngeal carcinoma is presented. actinomycosis should be considered in the differential diagnosis of dysphagia following radiotherapy for squamous cell carcinoma of the larynx, as early treatment is likely to result in a favourable outcome.
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4/16. actinomycosis of the face and neck.

    Cervical actinomycosis is a rare condition. During the last six years, five patients were hospitalized in our department, suffering from swelling in the region of the face and neck that was identified bacteriologically as actinomyces israelii. Soft tumors of the head and neck that do not respond to common antibiotic therapy should arouse the suspicion of actinomycosis.
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5/16. Pediatric cervicofacial actinomycosis: a case report.

    Cervicofacial actinomycosis affects many soft tissue and bony structures in the head and neck, and has both granulomatous and suppurative features. Pathogenesis of actinomycosis is still unclear, but trauma provides a portal of entry for the infection. It usually presents as a diffuse swelling with multiple sinus tracts containing macroscopic colonies of the organism known as "sulphur granules." Cervicofacial actinomycosis in children is rare. This article reports a case of actinomycosis in a 10-year-old-boy overlying the left ramus of the mandible.
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6/16. scalp actinomycosis mimicking soft tissue mass.

    actinomycosis is a rare, subacute or chronic bacterial infection, characterized by localized swelling with suppuration, abscess formation, tissue fibrosis, and draining sinuses. It is caused by gram-positive, pleomorphic non-spore-forming, non-acid-fast anaerobic or microaerophilic bacilli of the genus actinomyces. In humans, actinomyces are often normally found in the oral cavity, the gastrointestinal tract and the female genital tract. Infections of the oral and cervicofacial regions are the most commonly reported cases. We present a case of subcutaneous actinomycosis, localized at the upper segment of the posterior neck space, with scalp involvement.
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7/16. Chronic sinusitis unresponsive to medical therapy: a case of maxillary sinus actinomycosis focusing on computed tomography findings.

    actinomycosis of the paranasal sinuses is a rare occurrence and its clinical presentation does not suggest a specific diagnosis. Therefore, actinomycosis should be included in the differential diagnosis of neoplasms and granulomatous lesions of the head and neck region. However, the differentiation from a malignant neoplasm is not easy because the radiological findings are frequently similar and positive cultures are difficult to obtain. This report highlights the clinical progress of paranasal actinomycosis associated with some computed tomography findings that can be extremely helpful in the correct diagnosis. The characteristics of the disease are described and the relevant literature is discussed.
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8/16. Actinomycotic pseudo-tumour of the mid-cervical region (a case report).

    Cervicofacial actinomycosis is today a rare disease in our country. Isolated actinomycotic neck masses are extremely rare. A case of young man with an isolated midcervical tumour like actinomycotic granuloma without sinuses or discharging granules is reported here.
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9/16. actinomycosis: masquerader in the head and neck.

    The diagnosis of cervicofacial actinomycosis is usually not simple, but may be essential for adequate treatment. Cases seen in a head and neck Service illustrate some of the many guises under which actinomycosis may be concealed, and a review of recent literature confirms its propensity to be a masquerader. A combination of techniques is necessary to diagnose, and both surgical and medical approaches are needed to treat this often distressingly persistent affliction.
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ranking = 4
keywords = neck
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10/16. CT diagnosis of actinomycosis of the neck.

    actinomycosis is an unusual bacterial infection that most often affects the head and neck region. Abscesses occasionally associated with a draining sinus may result secondary to extensive tissue destruction. We report the CT appearance in a case of actinomycosis of the neck. A thick walled enhancing mass with a low attenuation center was identified between the sternocleidomastoid muscle and the strap muscles of the neck. Enhancement of the adjacent muscles was present. Surgery confirmed an abscess with inflammation of the adjacent muscle. Histologic examination of the specimen showed the presence of multiple yellow (sulfur) granules containing actinomyces. Computed tomography correctly determined the extent of the mass and lack of involvement of the deep structures of the neck.
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ranking = 8
keywords = neck
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