Actinomycosis and Sialolithiasis in Submandibular Gland

초록

Actinomycosis is a subacute or chronic suppurative infection caused by Actinomycesspecies, which are anaerobic Gram-positive bacteria that normally colonize the humanmouth and digestive and urogenital tracts. Cervicofacial actinomycosis is the mostfrequent clinical form of actinomycosis, and is associated with odontogenic infection. Characterized by an abscess and mandibular involvement with or without fistula, but thecervicofacial form of actinomycosis is often misdiagnosed because the presentation isnot specific and because it can mimic numerous infectious and non-infectious diseases,including malignant tumors. We report a rare case of actinomycosis infection with coexistingsubmandibular sialolithiasis. The patient presented with a 1×1 cm abscess-likelesion below the lower lip. Punch biopsy of the lesion revealed atypical squamous cellproliferation with infiltrative growth, suggestive of squamous cell carcinoma. The patientunderwent wide excision of this lesion, where the lesion was found to be an abscess formationwith multiple submandibular sialolithiases. The surgical specimen was found tocontain Actinomyces without any evidence of a malignant process. We assumed that associatedpredisposing factors such as poor oral hygiene may have caused a dehydratedcondition of the oral cavity, leading to coexistence of actinomycosis and sialolithiasis.

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