Oral Actinomycosis in a Patient With Acute Myeloid Leukemia: A Unique Clinical Insight

Actinomycosis is a chronic, suppurative, granulomatous bacterial infection caused by Actinomyces, a gram-positive anaerobic bacterium commonly present on mucosal surfaces. Although not classified as an opportunistic infection, it frequently affects immunocompromised individuals.

We report the case of a 54-year-old woman with acute myeloid leukemia who developed oral mucosal pain, odynophagia, and severe halitosis during hospitalization. Clinical examination revealed two ulcerated lesions on the hard palate, with a reported progression over three months. Computed tomography showed a perforation in the anterior maxilla. Due to severe thrombocytopenia (10 000/mm³), a biopsy was performed after platelet transfusion. The differential diagnosis initially included leukemic infiltration, oral carcinoma, and opportunistic infection. Histopathological analysis confirmed the diagnosis of actinomycosis. The patient was treated with oral Amoxicillin 1 g every 12 hours.

Diagnosing Actinomyces infections can be challenging due to their varied clinical presentations and similarity to malignant lesions. Despite its rarity, actinomycosis should be considered in the differential diagnosis of ulcerated palatal lesions, especially in immunocompromised patients.