ABSTRACT
Cervicofacial actinomycosis is a common form of Actinomyces infection. However, the latter seldom occurs in the tongue. We present a case of a 66 year-old man with macroglossia caused by actinomycosis of the tongue. Radiographic features were compatible with a chronic inflammatory disease. Biopsies revealed granulomas containing giant cells and Gram positive bacterial clusters consistent with actinomycosis. The patient was treated with a 22 week course of antibiotics. Imaging showed a notable improvement in the extent of the lesions 1 year later. The patient was asymptomatic and in good condition during his second year follow-up. Diagnosis of actinomycosis of the tongue can prove to be challenging because of the non-specific nature of its symptoms, clinical signs, and radiographic features. Isolation of Actinomyces sp. is an added diagnostic hurdle, because of its fastidious nature.
Subject(s)
Actinomycosis, Cervicofacial/pathology , Macroglossia/microbiology , Aged , Humans , MaleABSTRACT
Histoplasmosis is an endemic deep mycosis produced by Histoplasma capsulatum, a dimorphic fungus. It penetrates into the organism by inhalation and spreads by lymphatic or hematic route. We report a 57-year-old immunocompetent male presenting with an enlargement of the tongue that also exhibited white pseudomembranes. There were also nodular lesions in the dorsum of the tongue, separated by deep grooves. The pathological study revealed a chronic inflammatory process with granulomas. The microbiological examination with the Giemsa technique showed multiple yeasts of 4-5 mm of diameter with a clear halo inside macrophages and epithelial cells, compatible with the parasitic phase of Histoplasma capsulatum. Serology was positive for the histoplasmine antigen. The patient was treated with Itraconazole 200 mg/day, experiencing 40% remission of lesions during the first month of treatment.
Subject(s)
Histoplasmosis/complications , Macroglossia/microbiology , Argentina , Histoplasma , Histoplasmosis/pathology , Humans , Macroglossia/pathology , Male , Middle AgedABSTRACT
Histoplasmosis is an endemic deep mycosis produced by Histoplasma capsulatum, a dimorphic fungus. It penetrates into the organism by inhalation and spreads by lymphatic or hematic route. We report a 57-year-old immunocompetent male presenting with an enlargement of the tongue that also exhibited white pseudomembranes. There were also nodular lesions in the dorsum of the tongue, separated by deep grooves. The pathological study revealed a chronic infammatory process with granulomas. The microbiological examination with the Giemsa technique showed multiple yeasts of 4-5 mm of diameter with a clear halo inside macrophages and epithelial cells, compatible with the parasitic phase of Histoplasma capsulatum. Serology was positive for the histoplasmine antigen. The patient was treated with Itraconazole 200 mg/day, experiencing 40 percent remission of lesions during the frst month of treatment.
