Cervicofacial actinomycosis: a report of 14 patients observed at the Dermatology Unit of the University of Milan, Italy

[Cervicofacial actinomycosis]

Actinomycosis is an infectious disease caused by gram-positive, facultative anaerobic bacteria, which in most cases manifests itself in the cervicofacial area and often has a dentogenic focus. The clinical presentation ranges from acute abscess to chronically fistulating soft tissue processes. Early diagnosis and an appropriate therapeutic approach including a combination of extensive antibiotic treatment and, if necessary, surgical intervention are critical. This article presents five cases of actinomycete infections, which are intended to illustrate the variety of clinical presentations, the problems on the way to the correct diagnosis and possible therapeutic courses.

Surgical debridement as a treatment strategy for cervicofacial actinomycosis-Literature review and case report

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Antibiotic therapy and surgical debridement as a form of treatment of actinomycosis.

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Actinomycosis does not respond well antibiotic therapy before curettage.

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Debridement proved to be important for the reduction of antibiotic therapy time.

Introduction

Actinomycosis is a rare chronic disease caused by bacterial infection of the Actinomyces genus. Standard treatment usually involves drainage and high doses of antibiotic therapy, which takes between 6–12 weeks for complete resolution.

Presentation of case

A 57-year-old male was admitted with soft tissue infection-like inflammation of the parasymphysis region, further diagnosed as cervicofacial actinomycosis. Treatment comprised of surgical debridement associated with antibiotic therapy, which took only 4 weeks for complete healing.

Discussion

Although surgical debridement isn’t part of the standard treatment, it has shown to be an interesting tool for promoting quick healing and infection control.

Conclusion

The authors reported a successfully treatment of cervicofacial actinomycosis using surgical debridement as an adjuvant therapy, promoting faster healing, reducing antibiotic therapy time, costs and risks of bacterial resistance, which must be considered as an alternative approach in similar cases.