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만성 비침습성 비강 방선균증 1예

A Case of Chronic Noninvasive Actinomycosis in the Nasal Cavity

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주제분류이비인후과학

초록

Actinomycosis is a rare anaerobic, gram-positive bacterial infection caused by Actinomyces, which is a normal flora in the gastrointestinal and female genitourinary tracts. The cervicofacial area is a common infection site for actinomycosis, while nasal cavity is rare. Generally, standard treatment of the disease is a long term antibiotics therapy. However, a treatment strategy for nasal actinomycosis has not been established due to its rarity. We present a case of nasal actinomycosis that was managed by surgical removal. A 49-year-old woman visited our clinic with epistaxis and foul odor and nasoendoscopy showed a mass in patient’s right nasal cavity. The mass comprised of Actinomyces was easily removed by endoscopic surgery. Further histopathologic examination revealed that the surrounding tissues did not contain Actinomyces, so we stopped applying antibiotics to the patients. No recurrence has been observed for 26 months. We report this rare case of nasal actinomycosis with a literature review regarding treatment. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(3):144-7

Abstract

Actinomycosis is a rare anaerobic, gram-positive bacterial infection caused by Actinomyces, which is a normal flora in the gastrointestinal and female genitourinary tracts. The cervicofacial area is a common infection site for actinomycosis, while nasal cavity is rare. Generally, standard treatment of the disease is a long term antibiotics therapy. However, a treatment strategy for nasal actinomycosis has not been established due to its rarity. We present a case of nasal actinomycosis that was managed by surgical removal. A 49-year-old woman visited our clinic with epistaxis and foul odor and nasoendoscopy showed a mass in patient’s right nasal cavity. The mass comprised of Actinomyces was easily removed by endoscopic surgery. Further histopathologic examination revealed that the surrounding tissues did not contain Actinomyces, so we stopped applying antibiotics to the patients. No recurrence has been observed for 26 months. We report this rare case of nasal actinomycosis with a literature review regarding treatment. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(3):144-7

참고문헌 (10)

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  3. Moghimi M, "Treatment of cervicofacial actinomycosis: a report of 19 cases and review of literature", Med Oral Patol Oral Cir Bucal, 18(4), pp.e627~e632 (2013)
  4. Batzakakis D, "Nasal actinomycosis mimicking a foreign body", Ear Nose Throat J, 92(7), pp.E14~E16 (2013)
  5. 김상덕, "하비도에서 발생한 방선균에 의한 누소관염 1예", 대한이비인후과학회지 두경부외과학, 51(2), pp.183~185 (2008), 대한이비인후과학회
  6. 이경철, "비강에 발생한 방선균증 1예", Journal of Rhinology, 14(2), pp.128~130 (2007), 대한비과학회
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  8. Sakuma Y, "Actinomycosis arising from the nasal cavity, with rare fatal progression", BMJ Case Rep, 2016 (2016)
  9. Ozcan C, "Actinomycosis of the middle turbinate: an unusual cause of nasal obstruction", Eur Arch Otorhinolaryngol, 262(5), pp.412~415 (2005)
  10. Fishe AM, "Actinomycosis: some concepts of therapy and prognosis", Postgrad Med, 19(1), pp.32~35 (1956)

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