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(a) Photomicrograph showing colonies of Actinomyces sp. (H&E, 100Â), (b) photomicrograph showing loss of polarity, nuclear enlargement and anisonucleosis. (H&E, 400Â).
Context in source publication
Context 1
... even on extensive serial sectioning, there was no evidence of invasion. Areas of necrosis alongwith colonies of Actinomyces sp were found (Figure 1). These colonies were positive on Gram stain and Gomori's methana- mine silver (black colonies) (Figure 2), but they were not acid fast. ...
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Introduction
Actinomycosis is a granulomatous infection that rarely involves the larynx or pharynx. Three cases of actinomycosis of the larynx or pharynx from our institution were reviewed and a systematic literature review was performed to better define surgical management, antibiotic therapy, risk factors, and incidence of recurrence or complications.
Materials and methods
PubMed/Medline, Cochrane, Embase, and Google Scholar were searched on November 30, 2021 using the terms “laryngeal actinomycosis”, “pharyngeal actinomycosis”, “actinomycosis AND larynx”, and “actinomycosis AND pharynx.” Articles which did not describe appropriate sites or were non-English were excluded. Results were collected for demographic information, site (s) of infection, comorbidities, lesion characteristics and treatments.
Results
Along with three cases reported from our institution, 40 unique cases were reviewed from 37 studies for a total of 43 patients (Table 1). 34 (81.0 %) of the patients were male with the highest incidence of infection in the seventh decade (54.8 %). The most common site for the infection was the larynx (69.0 %) followed by the pharynx (16.7 %). Risk factors included a history of radiation therapy, immunosuppression, inhalational irritant, and diabetes (Table 3). The duration of antibiotic therapy varied greatly, from one month to one year and total follow up ranged from 1 month to 2.5 years (Table 1).
Conclusions
A comprehensive review of the literature on pharyngolaryngeal actinomycosis shows that this infection has increased prevalence within the head and neck cancer patient population. Similar to cervicofacial actinomycosis, these atypical sites have shown favorable responses to extended antibiotic therapy and generally do not require aggressive surgical management.
