Department of Otorhinolaryngology-Head and Neck Surgery.
Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
J Med Invest. 2021;68(1.2):202-204. doi: 10.2152/jmi.68.202.
Actinomycosis is an infection caused by anaerobic bacteria, primarily from the genus Actinomyces, which normally colonize the several regions including the mouth. Disruption of mucosa may lead to infection of virtually any site, but reports of involvement of the sinuses are rare. We report a case of an actinomycosis infection in the unilateral maxillary sinus. A 47-year-old female visited our hospital with a complaint of mild pain of left buccal region. Computed tomography (CT) revealed that the left maxillary and anterior ethmoidal sinus cavities were opacified along with a calcified fragment located close to the natural ostium. Thus, we provisionally diagnosed as a fungal sinusitis. She underwent trans-nasal endoscopic sinus surgery. The sinuses were opened and the caseous material was removed. The histopathological examination suggested an actinomycosis, but not fungal, infection. The patient's postoperative course was uneventful. No evidence of recurrence has been seen over the 30 months of the postoperative follow-up period. In case of the aggressive actinomycotic sinusitis, extension into the adjacent organs could be occurred. We should be aware that sinusitis of actinomycosis infection could progress in patients with risk factors such as diabetes and immunodeficiency. J. Med. Invest. 68 : 202-204, February, 2021.
放线菌病是一种由厌氧菌引起的感染，主要来自放线菌属，这些细菌通常定植于包括口腔在内的多个区域。黏膜的破坏可能导致任何部位的感染，但鼻窦受累的报告却很少见。我们报告了一例单侧上颌窦放线菌病感染。一名 47 岁女性因左侧颊部轻度疼痛就诊于我院。计算机断层扫描（CT）显示左侧上颌窦和前筛窦腔混浊，同时靠近自然窦口处有一个钙化碎片。因此，我们初步诊断为真菌性鼻窦炎。她接受了经鼻内镜鼻窦手术。打开鼻窦并清除干酪样物质。组织病理学检查提示为放线菌感染，但不是真菌感染。患者术后恢复顺利。在术后 30 个月的随访期间，未见复发迹象。在侵袭性放线菌性鼻窦炎的情况下，可能会向邻近器官扩散。我们应该意识到，患有糖尿病和免疫缺陷等危险因素的患者，放线菌感染性鼻窦炎可能会进展。医学研究杂志 68：202-204，2021 年 2 月。
