Abstract
Actinomycosis of the paranasal sinuses is a rare occurrence and its clinical presentation does not suggest a specific diagnosis. Therefore, actinomycosis should be included in the differential diagnosis of neoplasms and granulomatous lesions of the head and neck region. However, the differentiation from a malignant neoplasm is not easy because the radiological findings are frequently similar and positive cultures are difficult to obtain. This report highlights the clinical progress of paranasal actinomycosis associated with some computed tomography findings that can be extremely helpful in the correct diagnosis. The characteristics of the disease are described and the relevant literature is discussed.
References
1. Miller M, Haddad AJ. Cervicofacial actinomycosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85: 496–508.
2. Podoshin L, Rosenman D, Fradis M, Wallish G. Cervicofacial actinomycosis. Ear Nose Throat J 1989; 68: 559–561.
3. Roth M, Montone KT. Actinomycosis of the paranasal sinuses: a case report and review. Otolaryngol Head Neck Surg 1996; 114: 818–821.
4. Nagler R, Peled M, Laufer D. Cervicofacial actinomycosis: a diagnostic challenge. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 83: 652–656.
5. Curi MM, Dib LL, Kowalski LP, Landman G, Mangini C. Opportunistic actinomycosis in osteoradionecrosis of the jaws in patients affected by head and neck cancer: incidence and clinical significance. Oral Oncol 2000; 36: 294–299.
6. Kwartler JA, Limaye A. Pathologic quiz case 1. Cervicofacial actinomycosis. Arch Otolaryngol Head Neck Surg 1989; 115: 524–527.
7. Hirshberg A, Tsesis I, Metzger Z, Kaplan I. Periapical actinomycosis: a clinicopathologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 95: 614–620.
8. Ermis I, Topalan M, Aydin A, Erer M. Actinomycosis of the frontal and parotid regions. Ann Plast Surg 2001; 46: 55–58.
9. Alamillos-Granados FJ, Dean-Ferrer A, García-López A, López-Rubio F. Actinomycotic ulcer of the oral mucosa: an usual presentation of oral actinomycosis. Br J Oral Maxillofac Surg 2000; 38: 121–123.
10. Baliga S, Shenoy S, Wilson G, Katara V. An unusual case of actinomycosis. Ear Nose Throat J 2002; 81: 44–45.
11. Pinto Leite A, Carlos Costa J, Gouvea M, Pinto Leite C, Portal J, Oliveira J. Sinusites mycotiques. Apport de la tomodensitométrie. Ann Radiol 1992; 35: 73–76.
12. Pradhan S, Datta NR, Prasad KN, Ayyagari S, Pandey R. Actinomycosis mimicking carcinoma of the maxillary sinus. Indian J Cancer 1993; 30: 1–4.
13. Bhatia PI, Obafunwa JO. Rare infections of nose and paranasal sinuses. Trop Geogr Med 1990; 42: 289–293.
14. Kingdom TT, Tami TA. Actinomycosis of the nasal septum in a patient infected with the human immunodeficiency virus. Otolaryngol Head Neck Surg 1994; 111: 130–133.
15. Oliverio PJ, Zinreich SJ. Radiology of the nasal cavity and paranasal sinuses. In: Otolaryngology head and neck surgery. V.02. St. Louis, MO: Mosby; 1998, pp 1079–1091.
16. Sa'do B, Yoshiura K, Yuasa K, Ariji Y, Kanda S, Oka M, Katsuki T. Multimodality imaging of cervicofacial actinomycosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1993; 76: 772–782.
17. Braun JJ, Bourjat P. CT imaging of fungal and non-fungal caseous sinusitis. A report of 50 cases. J Radiol 2000; 81: 227–231.
18. DelGaudio JM, Swain Jr RE, Kingdom TT, Muller S, Hudgins PA. Computed tomographic findings in patients with invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg 2003; 129: 236–240.
19. Mukherji SK, Figueroa RE, Ginsberg LE, Zeifer BA, Marple BF, Alley JG, et al. Allergic fungal sinusitis: CT findings. Radiology 1998; 207: 417–422.
20. Silverman CS, Mancuso AA. Periantral soft-tissue infiltration and its relevance to the early detection of invasive fungal sinusitis: CT and MR findings. Am J Neuroradiol 1998; 19: 321–325.
21. Özcan C, Talas D, Görür K, Aydin Ö, Yildiz A. Actinomycosis of the middle turbinate: an unusual cause of nasal obstruction. Eur Arch Otorhinolaryngol 2005; 262: 412–415.
22. Okuyemi KS, Tsue TT. Radiologic imaging in the management of sinusitis. Am Fam Physician 2002; 66: 1882–1886.
23. Guo YC, Lan MY, Tai SK, Chang SY, Chen W. Pathology quiz case 1. Actinomycosis of the submandibular area mimicking a malignancy. Arch Otolaryngol Head Neck Surg 2002; 128:1099, 1101.
24. Silver AJ, Baredes S, Bello JA, Blitzer A, Hilal SK. The opacified maxillary sinus: CT findings in chronic sinusitis and malignant tumors. Radiology 1987; 163: 205–210.

