Actinomycosis of maxillary antrum presenting as nasal polypi: a rare case

Authors

  • K. C. Prasad Department of ENT, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
  • Harshitha N. Department of ENT, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
  • Azeem Mohiyuddin S. M. Department of ENT, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
  • Harshita T. R. Department of ENT, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
  • Indu Varsha Department of ENT, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
  • Vswashanthi Pondala Department of ENT, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20193900

Keywords:

Actinomycosis, Maxillary antrum, Nasal polypi

Abstract

Actinomycosis is a rare anaerobic bacterial infection that presents in the form of cervicofacial, pulmonary, thoracic and abdominopelvic infections. It is usually caused by Actinomyces israelii which are a part of normal flora of aerodigestive tracts. They are opportunistic pathogens and cause infections which have odontogenic origin in oral cavity. Cervicofacial actinomycosis accounts for more than half of the cases and commonly affects the mandible. We are reporting a case of actinomycosis of left maxillary antrum presenting as a nasal polypi in a young man. He had presented with nasal discharge and yellowish crusts from left nasal cavity. Diagnostic nasal endoscopy revealed yellowish polypoidal mass arising from the left middle meatus. CT PNS showed soft tissue density mass measuring 3.7×4.3×4.1 cms in left maxillary antrum extending through and obliterating osteomeatal complex extending into left ethmoidal sinus. Patient underwent Functional endoscopic sinus surgery. The yellowish polypoidal mass in left nasal cavity was attached to the floor of the maxillary antrum by a thin stalk and had filled up the antrum. Histopathology of the specimen revealed inflammatory polyp with actinomycosis. Patient had an uneventful recovery and was put on long term antibiotics and regular follow up.

References

Vorasubin N, Wu AW, Day C, Suh JD. Invasive sinonasal actinomycosis: case report and literature review. Laryngoscope. 2013;2:334-8.

Sánchez Legaza E, Cercera Oliver C, Miranda Caravallo JI. Actinomycosis of the paranasal sinuses. Acta Otorrinolaringol Esp. 2013;4:310-1.

Stanton MB. Actinomycosis of the maxillary sinus. J Laryngol Otol. 1966;80(2):168-74.

Damante JH, Sant'Ana E, Soares CT, Moreira CR. Chronic sinusitis unresponsive to medical therapy: a case of maxillary sinus actinomycosis focusing on computed tomography findings. Dentomaxillofac Radiol. 2006;35(3):213-6.

Sakuma Y, Yamashita Y, Shiono O, Oridate N. Actinomycosis arising from the nasal cavity, with rare fatal progression. BMJ Case Rep. 2016:bcr2015213747.

Valour F, Sénéchal A, Dupieux C, Karsenty J, Lustig S, Breton P, et al. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infect Drug Resist. 2014;7:183-97.

Meethal AC, Pattamparambath M, Balan A, Kumar NR, Sathyabhama S. Actinomycotic Osteomyelitis of the Maxilla - A Delusive Presentation. Meethal AC, Pattamparambath M, Balan A, Kumar NR, Sathyabhama S. J Clin Diagn Res. 2016;10(7):1-3.

Fadda GL, Gisolo M, Crosetti E, Fulcheri A, Succo G. Intracranial complication of rhinosinusitis from actinomycosis of the paranasal sinuses: a rare case of abducens nerve palsy. Case Rep Otolaryngol. 2014:601-71.

Padiyar V, Mohiyuddin A, Parimala S. Maxillary Sinusitis and Ethmoidal Polypi due to Nocardia: A Rare Case. Ann Clin Otolaryngol. 2016;1(1):1002.

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Published

2019-08-27