Abstract
Actinomycosis is an indolent, slowly progressive infection caused by anaerobic bacteria, primarily from the genus Actinomyces, which normally colonize the mouth, bronchial tubes, colon, and vagina. Disruption of
mucosa may lead to infection of virtually any site. Four clinical forms of actinomycosis are recognized: 1)
cervicofacial, 2) thoracic, 3) abdominal, and 4) genital. About 40–60% of cases occur in the head and neck
region, but reports of involvement of the nose and sinuses are extremely rare. We report here a case of actinomycosis of the nasal cavity. A 19-year-old female visited our clinic with a complaint of headache and left nasal obstruction. She did not have maxillofacial or oral trauma or dental treatment such as tooth extraction. Granulation and a blackish brown lesion were found in the inferior meatus. Plain CT revealed mucosal hypertrophy of the left inferior turbinate and calcification in the inferior meatus. A biopsy was performed, and the lesion was diagnosed as actinomycosis by histopathological examination. The patient was treated with oral penicillin (AMPC 1500 mg/day) for 8 weeks and the residual lesion in the inferior meatus was excised under topical anesthesia. Then, oral penicillin (AMPC 1500 mg/day) was administered again for 4 weeks. However, since the paranasal lesion remained, endoscopic sinus surgery (ESS) was performed under general anesthesia 4 months after the first surgery. To date, one year after the ESS, no recurrence has been observed.
