A Rare Case of Submandibular Actinomycosis

Actinomycosis is caused by actinomyces israelii, a gram positive nonacid fast, anaerobic, commensal bacterium within the oral cavity. Though it is a commensal in oral cavity, it seldom presents as cervicofacial actinomycosis. But there is limited access to literature proving cervicofacial actinomycosis existence so far. We report a case of 35 year old gentleman who presented with painless progressive neck swelling associated with pain while chewing food. On examination, 3.5*2.5 swelling was noted in right submandibular gland area, radiologically a foreign body was detected in the right submandibular gland. Mass was excised in toto and sent for HPE which revealed submandibular gland actinomycosis. Post operatively, patient was managed with long-term broad-spectrum beta lactams and was on regular follow-up. No evidence of recurrence/ fresh complaints noted till date. Although cervicofacial actinomycosis is rare and dangerous with debilitating complications, timely diagnosis and early intervention with broad spectrum antibiotics and surgical excision (if required) shows promising results with complete eradication of disease leaving no residues.