An infection of the head and neck is the most common presentation for Actinomycosis.
Risk factors for craniofacial actinomycosis:
(1) poor dentition
(2) dental manipulation
(3) chronic tonsillitis
(4) head and neck trauma or surgery
Clinical features may include:
(1) acute abscess
(2) "lumpy jaw" with development of a mass in the submandibular region or at the angle of the mandible
(3) chronic otitis
(4) mastoiditis
(5) other chronic abscess, often with draining sinuses
(6) periostitis or osteomyelitis
Microscopic examination of material aspirated from a lesion or collected from drainage may show sulfur granules. Proper culturing is essential for isolation of the organism.
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