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Published on: June 2, 2011
Nasopharyngeal actinomycosis
Lamia Ouertatani1, Yassine Jeblaoui, Salima Kharrat
1Service d'ORL et de Chirurgie Maxillo-Faciale, Hopital la Rabta, Tunis 1007, Tunisia.
Abstract:
Nasopharyngeal actinomycosis is a rarely encountered bacterial infection which usually occurs after nasal trauma or surgery. In some clinical cases, nasopharyngeal actinomycosis has appeared in patients without prior trauma, making diagnosis difficult. Here we present three such cases successfully treated with appropriate dosages of penicillin. One 16-year-old boy with no previous medical antecedents showed an important thickening of the posterior wall of the nasopharynx. A similar nasopharyngeal thickening was found in a 42-year-old woman exhibiting poor dental hygiene. In another 42-year-old woman, nasopharyngeal inflammation was accompanied by multiple right lymphoadenopathies. Like the first two patients, the woman had no prior trauma but did exhibit poor dental hygiene and teeth rottenness. In all three patients, actinomycosis diagnosis was confirmed by anaerobic microbial culturing of the biopsy specimen. Although diagnosis is delayed in patients with no prior trauma, treatment with antibiotics has greatly improved the prognosis for all forms of actinomycosis, and neither death nor deformity is common.
Insights
Nasopharyngeal actinomycosis, a rare bacterial infection, can occur without prior trauma. This study highlights three cases successfully treated with penicillin, improving prognosis.
Area of Science:
- Infectious Diseases
- Bacteriology
- Otolaryngology
Background:
- Nasopharyngeal actinomycosis is a rare bacterial infection.
- It typically follows nasal trauma or surgery but can occur idiopathically.
- Idiopathic cases present diagnostic challenges.
Observation:
- Presents three cases of nasopharyngeal actinomycosis in patients without prior trauma.
- Case 1: 16-year-old boy with posterior nasopharyngeal wall thickening.
- Case 2 & 3: 42-year-old women with nasopharyngeal thickening/inflammation, poor dental hygiene, and lymphadenopathy.
Findings:
- Diagnosis confirmed via anaerobic microbial culturing of biopsy specimens.
- Penicillin treatment was successful in all three patients.
- Delayed diagnosis in trauma-unrelated cases did not impede successful treatment.
Implications:
- Antibiotic therapy, particularly penicillin, is effective for nasopharyngeal actinomycosis.
- Early diagnosis and treatment significantly improve patient outcomes.
- Highlights the importance of considering actinomycosis even without a history of trauma.
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