Actinomycosis of the Tongue: A Case Report and Review of Literature

Abstract

Background: Actinomycosis of the tongue is an uncommon, suppurative infection of lingual mucosa, caused by actinomyces. The clinical diagnosis may present serious difficulties because of its ability to mimic other lesions, including both benign and malignant neoplasms. Methods: Here, we describe the case of a 52-years-old patient affected by an asymptomatic, tumor-like tongue swelling, then diagnosed as actinomycosis. A review of tongue localization of actinomycosis is also reported, with emphasis on clinical findings and therapy. Results and Conclusion: Early diagnosis and treatment, with pus drainage and systemic antibiotic therapy, are pivotal to avoid severe and life-threatening complications.

Keywords: oral actinomycosis; oral infection; oral lesion; tongue actinomycosis; tongue lesion.

Figure 1

Tongue nodular lesion, as observed at first examination: the localized swelling on the lingual dorsum was covered by normal mucosa. (a) Frontal view of the lesion, (b) lateral view of the lesion.

Figure 2

Complete resolution of the lesion at six weeks, after incisional biopsy with pus drainage and one-week antibiotic therapy.

Figure 3

Histopathological examination of the lesion. At small magnification (20×; H&E) the oral mucosa shows acute and chronic intense inflammatory infiltration and, at one side of the sample, two aggregates (a) better assessed at high magnification (60×) (b) and after PAS staining (c) consistent with Actinomyces spp. colonies. The colonies are composed of Actinomyces spp. filaments, called “sulfurs granules”, surrounded by neutrophilic granulocytes.