Complicated actinomycosis of the temporal bone: A historical case report

Abstract Introduction Actinomycosis is a chronic infection caused by anaerobic Gram-positive bacteria belonging to the Actinomyces family. The zones of predilection of this infection are mainly the head, neck and abdominal regions. Case report We report the case of a 30-year-old man admitted for agg...

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Bibliographic Details
Published in:European annals of otorhinolaryngology, head and neck diseases head and neck diseases, 2015-09, Vol.132 (4), p.227-229
Main Authors: Oukessou, Y, Ait Elkerdoudi, M, Abada, R.L, Mahtar, M
Format: Article
Language:English
Subjects:
Actinomyces israelii
Actinomycosis
Actinomycosis - diagnosis
Actinomycosis - therapy
Adult
Anti-Bacterial Agents - therapeutic use
Facial nerve palsy
Facial Paralysis - microbiology
Hearing Loss, Sensorineural - microbiology
Humans
Male
Mastoid - surgery
Mastoiditis - microbiology
Mastoiditis - therapy
Otolaryngology
Sensorineural hearing loss
Temporal bone
Temporal Bone - microbiology
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Summary:Abstract Introduction Actinomycosis is a chronic infection caused by anaerobic Gram-positive bacteria belonging to the Actinomyces family. The zones of predilection of this infection are mainly the head, neck and abdominal regions. Case report We report the case of a 30-year-old man admitted for aggressive right oto-mastoiditis complicated by facial nerve palsy and sensorineural hearing loss. CT scan demonstrated extensive destruction of the temporal bone. The patient underwent radical mastoidectomy followed by long-term antibiotic therapy. Discussion Its non-specific symptoms and atypical course, combined with difficult isolation of the causative agent, make actinomycosis a difficult infection to diagnose. Actinomycosis very rarely involves the temporal region, as fewer than 30 cases have been reported in the literature. Treatment of this form of actinomycosis is based on surgery and prolonged antibiotic therapy. Surgical treatment is designed to reduce the bacterial load by mechanical debridement and create aerobic conditions. Conclusion Compared to other cases reported in the literature, the case of temporal actinomycosis reported here was distinguished by its highly aggressive nature. Temporal actinomycosis should be suspected in the context of chronic otitis media with an atypical course. Treatment is based on a combination of surgery and antibiotics.
ISSN:1879-7296
1879-730X
DOI:10.1016/j.anorl.2015.03.006