title: Fatally invasive actinomycosis masquerading as a tonsillar carcinoma.
abstract: BACKGROUND
  Actinomyces is a bacterial rod found in the normal oral flora. It can gain entry to the submucosa via trivial wounds and ultimately lead to slow growing lesions which may mimic cancerous lesions.
  
  
  RESULTS
  We present the case of an elderly, immunosuppressed woman who presented with a herald bleed from a tonsillar lesion. Despite initial operative arrest of the hemorrhage, she died of a carotid blowout. At autopsy, no sign of cancer was found, but rather an invasive actinomycosis.
  
  
  CONCLUSIONS
  Although actinomycosis of the tonsil is well known and has even been described as mimicking tonsillar cancer, this is, to our knowledge, the first report of a carotid blowout secondary to actinomycosis.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Pézier
authors.forename: Nikos
authors.initials: N
authors.lastname: Kastrinidis
authors.forename: Gian-Marco
authors.initials: GM
authors.lastname: Widmer
authors.forename: Gerhard F
authors.initials: GF
authors.lastname: Huber
authors.forename: Rudolf
authors.initials: R
authors.lastname: Probst
mesh_terms: D000196:Actinomycosis / Q000150:complications* / Q000175:diagnosis*; D000368:Aged; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000382:microbiology*; D002342:Carotid Artery, External; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D014067:Tonsillar Neoplasms / Q000175:diagnosis*
keywords: actinomycosis; carotid blowout; herald bleed; immune suppression; squamous cell cancer; tonsillar cancer