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Actinomycosis of the posterior triangle: a case report and review of the literature

Published online by Cambridge University Press:  29 June 2007

B. V. Burns ,
A. Al-Ayoubi ,
J. Ray ,
J. B. Schofield  and
J. C. Shotton
B. V. Burns*
Affiliation:
Department of Otolaryngology, Kent Country Ophthalmic and Aural Hospital, Maidstone, kent, Preston Hall Hospital, UK
A. Al-Ayoubi
Affiliation:
Department of Otolaryngology, Kent Country Ophthalmic and Aural Hospital, Maidstone, kent, Preston Hall Hospital, UK
J. Ray
Affiliation:
Department of Otolaryngology, Kent Country Ophthalmic and Aural Hospital, Maidstone, kent, Preston Hall Hospital, UK
J. B. Schofield
Affiliation:
Department of Cellular Pathology, Preston Hall Hospital, Preston Hall, Aylesford, UK
J. C. Shotton
Affiliation:
Department of Otolaryngology, Kent Country Ophthalmic and Aural Hospital, Maidstone, kent, Preston Hall Hospital, UK
*
Address for corresopndence: Dr B. V. Burns, Department of Otolaryngology, Kent Country Ophthalmic and Aural Hospital, Church Street, Maidstone, Kent ME14 1DT
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Abstract

Actinomycosis presents acutely as an abscess, or as a chronic lesion mimicking malignancy, tuberculosis, or aspergillosis. Most disease involves the mouth and its immediate site of lymphatic drainage, the anterior triangle of the neck. We present a case of actinomycosis at th e apex of th e posterior triangle, suspected of being a malignancy, and discuss the importance of being aware of this as a cause of neck lumps. The diagnosis is usually made late because of the difficulties in culturing the organism, or in identifying characteristic ‘sulphur granules’ in pus or biopsy specimens. For these reasons, the disease is underdiagnosed. When acute or chronic neck lesions prove difficult to diagnose, microscopy and prolonged anaerobi c culture of pus and biopsy specimens should be performed in addition to Ziehl-Neelsen staining, tuberculosis and fungal cultures. The tests should be repeated if negative. Specific treatment requires prolonged courses of antibiotics, despite adequate surgical excision, to prevent relapse.

Keywords

ActinomycosisNeck
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 11 , November 1997 , pp. 1082 - 1085
Copyright
Copyright © JLO (1984) Limited 1997

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