MAXILLARY ACTINOMYCOSIS MIMICKING MALIGNANCY: A CASE REPORT
Authors:
Moschonas G, Shihada A, Papakosta V, Vasiliou S.
Affiliation:
Department of Oral and Maxillofacial Surgery, University JosAttikon Hospital, School of Medicine, National and Kapodistrian University of Athens
Doi: 10.54936/haoms242p20
ABSTRACT:
Objectives: Actinomycosis is an uncommon soft tissue infection caused by Gram-positive, anaerobic bacteria, with infrequent bone involvement. Approximately 50% of cases affect head and neck region but involvement of the maxilla is rare (5,7%). This poster presents an unusual case of maxillary Actinomycosis extending into the maxillary sinus, with radiologic findings resembling a space occupying lesion. A brief review of the literature is also presented.
Materials and methods: A 48 year old male patient presented to the outpatient clinic complaining of an oroantral fistula in the edentulous area of 15, appearing 1 year ago after his hospitalization for covid-19. He reported extraction of all posterior upper right teeth 20 years ago. CT scan was undertaken, demonstrating an ill-defined lesion extending into the maxillary sinus causing extensive bone erosion. The patient underwent incisional biopsy and the histopathology report established the diagnosis of Actinomycosis.
Results: After consulting with infectious diseases Specialists, IV Ampicillin/Sulbactam and Metronidazole were administered and the patient underwent surgical debridement and closure of oroantral fistula with locoregional flaps. The patient was discharged after receiving 2 weeks of IV antibiotics and continued treatment with p.os Amoxicillin/Clavulanic acid for 3 months, without complications.
Conclusions: Actinomycosis is a rare entity, which often tends to mimic other pathologies such as granulomatous diseases or malignancy. Hence, it is important to encompass actinomycosis in the differential diagnosis of aggressive lesions of the mouth The initial diagnostic workup is frequently nonspecific, with only 10% of cases successfully identified. A definitive diagnosis is usually made only after surgical excision and histologic examination. Antibiotics are an essential part of treatment, with Penicillin being the drug of choice and usually administered for 2 to 12 months. Surgical therapy is often indicated for curettage of bone, resection of necrotic tissue, excision of sinus tracts, and drainage of soft tissue abscesses.
KEY WORDS:
Authors:
Moschonas G, Shihada A, Papakosta V, Vasiliou S.
Affiliation:
Department of Oral and Maxillofacial Surgery, University JosAttikon Hospital, School of Medicine, National and Kapodistrian University of Athens
Doi: 10.54936/haoms242p20
ABSTRACT:
Objectives: Actinomycosis is an uncommon soft tissue infection caused by Gram-positive, anaerobic bacteria, with infrequent bone involvement. Approximately 50% of cases affect head and neck region but involvement of the maxilla is rare (5,7%). This poster presents an unusual case of maxillary Actinomycosis extending into the maxillary sinus, with radiologic findings resembling a space occupying lesion. A brief review of the literature is also presented.
Materials and methods: A 48 year old male patient presented to the outpatient clinic complaining of an oroantral fistula in the edentulous area of 15, appearing 1 year ago after his hospitalization for covid-19. He reported extraction of all posterior upper right teeth 20 years ago. CT scan was undertaken, demonstrating an ill-defined lesion extending into the maxillary sinus causing extensive bone erosion. The patient underwent incisional biopsy and the histopathology report established the diagnosis of Actinomycosis.
Results: After consulting with infectious diseases Specialists, IV Ampicillin/Sulbactam and Metronidazole were administered and the patient underwent surgical debridement and closure of oroantral fistula with locoregional flaps. The patient was discharged after receiving 2 weeks of IV antibiotics and continued treatment with p.os Amoxicillin/Clavulanic acid for 3 months, without complications.
Conclusions: Actinomycosis is a rare entity, which often tends to mimic other pathologies such as granulomatous diseases or malignancy. Hence, it is important to encompass actinomycosis in the differential diagnosis of aggressive lesions of the mouth The initial diagnostic workup is frequently nonspecific, with only 10% of cases successfully identified. A definitive diagnosis is usually made only after surgical excision and histologic examination. Antibiotics are an essential part of treatment, with Penicillin being the drug of choice and usually administered for 2 to 12 months. Surgical therapy is often indicated for curettage of bone, resection of necrotic tissue, excision of sinus tracts, and drainage of soft tissue abscesses.
KEY WORDS: