Abstract
Actinomycosis is an uncommon, subacute to chronic, suppurative bacterial infection caused by Actinomyces Israelii. About 3% of all actinomycosis cases occur in the tongue, often affecting adult patients (mean age, 50 years). The clinical characteristics of actinomycosis can resemble malignant or benign tumors, and other infectious diseases. A 56-year-old woman was referred presenting an ulcerated lesion on the tongue 1 year ago. Intraoral examination revealed an edematous nodular lesion with an ulcerated surface, slightly symptomatic, on the midline dorsum of posterior tongue, suggesting nodular median rhomboid glossitis. Cytology smear was negative for fungus. After excisional biopsy, histopathological examination showed a chronic inflammatory infiltrate supported by a fibrovascular connective tissue stroma, and at the deepest part, broad basophilic areas surrounded by neutrophils, containing numerous filamentous bacilli, which were highlighted by Gram and Groccott-Gomori staining. The final diagnosis was lingual actinomycosis. Oral amoxicillin treatment (8/8 h for 2 weeks) was started, and after 1-month complete resolution was observed. Lingual actinomycosis is a rare lesion that must be recognized by dentists, because its early diagnosis and correct treatment reduce the possibility of a clinical complication that compromises the patient’s quality of life. Noteworthy, when located on the midline dorsum of posterior tongue, actinomycosis can simulate nodular median rhomboid glossitis, expanding its spectrum of clinical differential diagnosis.
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References
D’Amore F, Franchini R, Moneghini L, Lombardi N, Lodi G, Sardella A, Varoni EM (2020) Actinomycosis of the Tongue: a Case Report and Review of Literature. Antibiot (Basel) 9:124
Al-Rawee RY, Jawhar NMT, Saeed MM (2020) Challenge dilemma of actinomycosis in the tongue: review and case report. Int J Surg Case Rep 75:176–181
Atespare A, Keskin G, Erçin C, Keskin S, Camcioglu A (2006) Actinomycosis of the tongue: a diagnostic dilemma. J Laryngol Otol 120:681–683
Özcan Z, Aker FV, Gölcük VA (2021) Pathologist-performed palpation-guided fine needle aspiration cytology of lingual actinomycosis: a case report and review of literature. Diagn Cytopathol 49:E84–E88
Miyasaki Y, Asada K, Sato T, Tochihara S, Hirashita K, Ishibashi K (1999) A clinical and histopathological study on nodular median rhomboid glossitis. J Jap Soc Oral Muc Memb 5:86–91
Lago-Méndez L, Blanco-Carrión A, Diniz-Freitas M, Gándara-Vila P, García-García A, Gándara-Rey JM (2005) Rhomboid glossitis in atypical location: case report and differential diagnosis. Med Oral Patol Oral Cir Bucal 10:123–127
Silva EV, Lança MLA, Silveira HA, Bufalino A, Navarro CM, Ribeiro-Silva A, León JE, de Yamamoto L (2021) Nodular lesion on the posterior dorsal surface of the tongue. Oral Surg Oral Med Oral Pathol Oral Radiol 131:e145–e150
Delgado WA, Almeida OP, Vargas PA, León JE (2009) Oral ulcers in HIV-positive peruvian patients: an immunohistochemical and in situ hybridization study. J Oral Pathol Med 38:120–125
Harty S, Fleming P, Rowland M, Crushell E, McDermott M, Drumm B, Bourke B (2005) A prospective study of the oral manifestations of Crohn’s disease. Clin Gastroenterol Hepatol 3:886–891
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Jorge Esquiche León have received research Grants (2016/11419-0; 2022/07479-9 and 2022/12760-9) from State of São Paulo Research Foundation (FAPESP) and research Grant (304241/2021-0) from National Council for Scientific and Technological Development (CNPq), Brazil.
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All the authors, M.R.T.R; M.H.L.D; J.B.J; H.A.S; E.V.S; and J.E.L, contributed to the organization and manuscript drafting.
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Reyes, M.R.T., Dominguete, M.H.L., Javaroni, J.B. et al. Lingual Actinomycosis Clinically Simulating Nodular Median Rhomboid Glossitis: Literature Review and Report of Additional Case. Indian J Otolaryngol Head Neck Surg 75, 3984–3987 (2023). https://doi.org/10.1007/s12070-023-04045-0
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DOI: https://doi.org/10.1007/s12070-023-04045-0