Neck actinomycosis mesquerading as laryngeal carcinoma recurrence
in an Omani male
Muhammad Furrukh, Taha Mufti, Aisha Hamdani.
Abstract
Actinomycosis is a gram positive bacterium that grows in anoxic conditions. It usually involves cattle, yet remains human commensals, usually found in oral cavity as well as the GI tract. Under favourable conditions it may be responsible for human opportunistic infections that mimicks a tumor of the involved site/s and drains pus via skin sinuses resembling sulphur granules. Favourite harbouring sites includes cervico-facial area, lungs, colon and the central nervous system. We present a case of advanced supraglottic laryngeal squamous cell carcinoma which was found un-resectable initially, and was subsequently treated with radical chemo-radiotherapy. Intense radiation induced fibrosis and consequent ischemia provided perfect growth medium for actinomycosis that formed an inflammatory mass mimicking recurrence of the tumor and resulted in neck sinus. The infection responded very well to oral amoxicillin, while patient remains carcinoma free for over 5 years.
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