amoxicillin-potassium-clavulanate-combination and Paranasal-Sinus-Diseases

We report a case with review of literature of actinomycosis accompanied with aspergillosis arising in unilateral maxillary sinus, in which it was completely cured after endoscopic sinus surgery and short term antibiotic therapy. To the best of our knowledge, this is the first case report in literature reporting actinomycosis in combination with aspergillosis in the paranasal sinus. Also, we suggest short term antibiotic therapy within one month may be sufficient if the surgical opening of paranasal sinus involved by actinomycosis could be well preserved.

Topics: Actinomycosis; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Aspergillosis; Endoscopy; Female; Follow-Up Studies; Humans; Maxillary Sinus; Middle Aged; Nasal Obstruction; Paranasal Sinus Diseases; Therapeutic Irrigation

Actinomycosis is a rare anaerobic bacterial infection typically caused by Actinomyces israelii. Although part of normal flora in the oral cavity, and respiratory and digestive tracts, A israelii can give rise to pathologic infections most commonly reported in the oral cavity from odontogenic causes. We present a rare case of invasive actinomycosis presenting with extensive midface destruction involving the maxilla and paranasal sinuses, with mucosal necrosis mimicking an aggressive neoplasm. The diagnosis is usually reached only after histopathologic analysis showing characteristic sulfur granules with filamentous gram-positive, non-acid-fast bacteria. We review the literature on its epidemiology, clinical presentation, diagnosis, treatment, and prognosis.

Topics: Actinomycosis; Adjuvants, Pharmaceutic; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Diagnosis, Differential; Drug Therapy, Combination; Humans; Male; Middle Aged; Paranasal Sinus Diseases; Penicillin G; Positron-Emission Tomography; Probenecid; Tomography, X-Ray Computed