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Rhinolithiasis caused by Actinomyces with a foreign body
Teru Kamogashira1,2, Naoyuki Matsumoto1, Satoe Numakura3,4
1Department of Otolaryngology, Teikyo University Hospital, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8606, Japan.
Idcases
|February 27, 2020
Summary
A calcified foreign body in the nose caused Actinomyces infection in a patient. Successful treatment involved surgery and long-term penicillin, highlighting the importance of compliance for this fungal infection.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Actinomycosis is a rare bacterial infection caused by Actinomyces species.
- Nasal cavity actinomycosis is uncommon, often presenting with nonspecific symptoms.
- Calcified foreign bodies can serve as a nidus for microbial colonization and infection.
Purpose of the Study:
- To report a case of nasal cavity actinomycosis secondary to a calcified foreign body.
- To emphasize the diagnostic and therapeutic challenges in managing this rare condition.
- To highlight the importance of surgical intervention and prolonged antibiotic therapy.
Main Methods:
- Case presentation of a 39-year-old male with epistaxis and facial pain.
- Diagnostic imaging and endoscopic examination revealing a calcified mass in the nasal meatus.
- Surgical removal of the foreign body and histopathological identification of Actinomyces species.
- Treatment with intravenous Penicillin G followed by oral amoxicillin for 6 months.
Main Results:
- Successful surgical excision of the calcified foreign body and infected tissue.
- Identification of Actinomyces species from the removed mass.
- Complete resolution of symptoms and no recurrence at 1-year follow-up.
- Demonstrated efficacy of combined surgical and long-term antibiotic treatment.
Conclusions:
- Nasal cavity actinomycosis requires prompt diagnosis and aggressive management.
- Surgical debridement of the infected focus is crucial.
- Prolonged high-dose antibiotic therapy, particularly penicillin, is essential for eradication and preventing recurrence.
- Patient compliance with long-term antibiotic regimens is critical for favorable outcomes.
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