title: Cervical vertebral actinomycosis mimicking malignancy in a paediatric patient.
abstract: Actinomyces spp are found in the flora of the oral cavity and vagina and may cause infection with abscess formation and draining sinuses. Cervicofacial manifestations of actinomycosis involve head and neck soft tissue, however, spread to the cervical spine is rare. We report a case of an 8-year-old boy, presenting with neck pain for 1 month and denying a history of trauma or procedures. Radiography revealed an ulceration of the posterior oropharyngeal mucosa with a defect extending to the C1-C2 vertebra, mimicking a neoplastic process. The patient underwent laryngoscopy and multiple biopsies were taken from the ulcer and bone, showing severe osteomyelitis and intraosseous filamentous organisms, morphologically consistent with Actinomyces spp. The boy received long-term antibiotics with response to treatment. Actinomycosis has rarely been reported in the cervical vertebrae of paediatric patients. This should be considered as a differential diagnosis for such a presentation as prompt antibiotic treatment may be lifesaving.
authors.affiliation: Department of Diagnostic Pathology and Laboratory Medicine, Mount Sinai West, New York, New York, USA.
authors.forename: Shyam
authors.initials: S
authors.lastname: Prajapati
authors.affiliation: Department of Radiology, Mount Sinai West, New York, New York, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Yoon
authors.affiliation: Department of Radiology, Mount Sinai West, New York, New York, USA.
authors.forename: Carlos L
authors.initials: CL
authors.lastname: Benitez
authors.affiliation: Department of Diagnostic Pathology and Laboratory Medicine, Mount Sinai West, New York, New York, USA.
authors.forename: Arzu
authors.initials: A
authors.lastname: Buyuk
mesh_terms: D000197:Actinomycosis, Cervicofacial / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents