title: Complicated actinomycosis of the temporal bone: A historical case report.
abstract: BACKGROUND
  Actinomycosis is a chronic infection caused by anaerobic Gram-positive bacteria belonging to the Actinomyces family. The zones of predilection of this infection are mainly the head, neck and abdominal regions.
  
  
  METHODS
  We report the case of a 30-year-old man admitted for aggressive right oto-mastoiditis complicated by facial nerve palsy and sensorineural hearing loss. CT scan demonstrated extensive destruction of the temporal bone. The patient underwent radical mastoidectomy followed by long-term antibiotic therapy.
  
  
  CONCLUSIONS
  Its non-specific symptoms and atypical course, combined with difficult isolation of the causative agent, make actinomycosis a difficult infection to diagnose. Actinomycosis very rarely involves the temporal region, as fewer than 30 cases have been reported in the literature. Treatment of this form of actinomycosis is based on surgery and prolonged antibiotic therapy. Surgical treatment is designed to reduce the bacterial load by mechanical debridement and create aerobic conditions.
  
  
  CONCLUSIONS
  Compared to other cases reported in the literature, the case of temporal actinomycosis reported here was distinguished by its highly aggressive nature. Temporal actinomycosis should be suspected in the context of chronic otitis media with an atypical course. Treatment is based on a combination of surgery and antibiotics.
authors.affiliation: Department of otorhinolaryngology, 20 August 1953 Hospital, 4, rue Lahcen El Arjoune-ex Dalton, quartier des hôpitaux, BP 20360, Casablanca, Morocco. Electronic address: dr.oukessou@gmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Oukessou
authors.affiliation: Department of otorhinolaryngology, 20 August 1953 Hospital, 4, rue Lahcen El Arjoune-ex Dalton, quartier des hôpitaux, BP 20360, Casablanca, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Ait Elkerdoudi
authors.affiliation: Department of otorhinolaryngology, 20 August 1953 Hospital, 4, rue Lahcen El Arjoune-ex Dalton, quartier des hôpitaux, BP 20360, Casablanca, Morocco.
authors.forename: R L
authors.initials: RL
authors.lastname: Abada
authors.affiliation: Department of otorhinolaryngology, 20 August 1953 Hospital, 4, rue Lahcen El Arjoune-ex Dalton, quartier des hôpitaux, BP 20360, Casablanca, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Mahtar
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005158:Facial Paralysis / Q000382:microbiology; D006319:Hearing Loss, Sensorineural / Q000382:microbiology; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008417:Mastoiditis / Q000382:microbiology* / Q000628:therapy; D013701:Temporal Bone / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Actinomyces israelii; Actinomycosis; Facial nerve palsy; Sensorineural hearing loss; Temporal bone