A curious case of cervicofacial actinomycosis following third molar surgery

摘要

Actinomycosis is caused by branched, filamentous anaerobic Gram-positive bacteria called Actinomyces. It is a chronic granulomatous and suppurative infectious disease of which there are three variations; cervicofacial, abdominal and pulmonary. This infection is a rare complication of dental surgery and can have devastating consequences if left untreated. A 35-year-old male presented with a 2 month history of a swelling to his left cheek following the surgical removal of a lower third molar. A provisional diagnosis of an infected sebaceous cyst was made at a local clinic, and a course of Flucloxacillin was prescribed. To further investigate the lesion an ultrasound scan was performed and an aspirate taken for histopathological analysis. The results were found to be consistent with the clinical suspicion of actinomycosis. A multidisciplinary approach was adopted to manage the patient's case which included liaising with the medical microbiology team to deliver appropriate antimicrobial therapy. The aim of this case report is to highlight the importance of having a clinical suspicion of cervicofacial actinomycosis. This infectious disease can spread into adjacent soft tissues causing serious damage to local structures if not identified. Early diagnosis and management is essential for good outcomes.