Cervicofacial actinomycosis of the maxilla and HIV infection : a case report

Abstract

Cervicofacial actinomycosis (CA) is a rare infection caused by Actinomyces spp. and it is infrequently found in the maxilla. The factors associated with the host in the evolution of CA have not been clarified in the literature, and the relationship between actinomycosis and immunodepletion remains surrounded by controversy. CA diagnosis is not usually considered in maxilla injuries, and the potential aggressiveness of these lesions makes it more difficult to reach early diagnosis. This article reports a case of a 31 year old man with a history of drug abuse. The patient was HIV-positive and developed an extensive, destructive lesion in the maxilla. The diagnosis of CA was based on imaging examination and partial biopsy. The patient was treated with crystalline IV penicillin G and amoxicillin orally and preceded under follow-up. CA should be considered in the differential diagnosis of lesions in the maxilla, and health professionals have to pay particular attention when other systemic factors such as HIV infection and drugs abuse are present. CA should be included in the differential diagnosis of maxillary lesions, and healthcare professionals have to dedicate special attention to patients with systemic conditions such as HIV infection and drug abuse, which may intensify the development of more aggressive CA forms.