Case history
Case history #1
A 58-year-old man presents with recurrent headache and a 6-month history of a slowly growing right submandibular mass. He has no history of fever or chills but has poor dental hygiene. Ultrasound reveals cervical and submandibular lymphadenopathies on the same side as the mass, and there is a sinus tract with accompanying purulent discharge and sulfur granules next to a right lower molar. Subsequent extraction of the tooth discloses a periapical abscess, and an intramasseteric biopsy demonstrates a granulomatous inflammatory response with a central area of suppurative necrosis containing numerous gram-positive branching, filamentous hyphae.
Case history #2
A 76-year-old woman presents with a history of repeated symptomatic ileus after a colon resection 7 years ago. She has had no fever, weight loss, or fatigue. Exploratory surgery shows masses in the ileocecal region. These masses are associated with local chronic inflammation, fistula formation, and granulation.
Other presentations
Diverse rare manifestations of actinomycosis include primary cutaneous actinomycosis, inferior vena cava syndrome, acute cholecystitis, acute cardiac tamponade, actinomycosis of the humerus, and actinomycosis involving the proximal phalanx.[3][4][5][6]
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