gms | German Medical Science

Objective: This paper aims at presenting a case of nasal actinomycosis causing clinical symptoms and signs similar to those of a nasal foreign body.

Case report: It is the case of a 34 year old female complaining of putrid nasal breath and unilateral fetid purulent nasal discharge. During rigid nasal endoscopy a dark gray mass was observed. It was stuck to the middle and inferior nasal turbinate. Computed tomography scan findings posed the question of a nasal foreign body. We proceeded with surgical removal of the mass. The diagnosis of actinomycosis was confirmed histopathologically, as well as microbiologically.

Discussion: Whereas in the preantibiotic era actinomycosis was rather frequent, nowadays it is a medical rarity [1], [2], Actinomyces israelii being the most common etiologic agent. In the past Actinomyces israelii was believed to be fungus. Nowadays, it is described as a gram positive, anaerobic or microaerophilic rod forming branching filaments. Nasal actinomycosis is usually presented in the form of some kind of purulent abscess of the nose and antrum [3] .

Conclusion: We suggest that every clinician confronting with unilateral nasal symptoms and / or signs should have this clinical entity in mind, since it has justifiably been characterized as the “masquerader” [1], [4], of head and neck.