Actinomycosis in the Oropharynx- A case report

Actinomycosis is a rare infectious bacterial disease caused by Actinomyces species. We present a case of a 56-year-old patient who presented to the ear, nose and throat clinic of University Hospital -KDU(UHKDU) with throat irritation and foreign body sensation for two months. Examination of the throat revealed white patches on the posterior pharyngeal wall. The rest of the oral cavity was normal. Fiberoptic laryngoscopy revealed whitish patches at the base of the tongue, the posterior pharyngeal wall, and the vallecular area. Multiple samples were collected for culture and histology. Biopsy specimens revealed multiple basophilic spherical clusters of densely packed filaments resembling Actinomyces colonies in the tissue, and bacterial cultures showed pure growth of whitish dry colonies. At the reference laboratory, these colonies were identified as Actinomyces m. Antibiotic sensitivity testing showed susceptibility to penicillin and co-amoxiclav. The patient was treated with antibiotics for a total duration of 8 weeks and showed complete resolution of the lesions after 8 weeks. The patient was followed up in the clinic for 6 months, during which no recurrence was observed. Actinomyces infections of the head and neck, although uncommon, represent an important entity because of its varied presentation, difficult diagnosis, and long course of treatment.