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Case No. 462
2017-11-01~2017-11-30
출제자 : 유인선
Hit : 243
| Period | 2017-11-01~2017-11-30 |
|---|---|
| Diagnosis | Cervicofacial actinomycosis |
| Clinical information | M/56 C.C> 2주전부터 시작된 left lateral neck 의 palpable mass |
| Discussion | Cervicofacial actinomycosis - Chronic suppurative bacterial infection by Actinomyces species (m/c : A. israelii), Usually manifests with abscess formation, dense fibrosis, and draining sinuses - Clinical Features • Most commonly involves the cervicofacial region • Mainly odontogenic origin & develop in immunocompetent individuals & indolent and nonspecific symptoms • Risk factors : Poor dental hygiene, recent dental extraction, dental caries, oromaxillofacial trauma, chronic tonsillitis, otitis, mastoiditis, osteonecrosis caused by radiation or bisphosphonate therapy • Location : Angle of the jaw or submandibular area (m/c) > cheek > submental space > masticator space > TM joint - Imaging findings • Highly infiltrative and strongly enhancing mass with suppurative necrosis accompanied by no or a few reactive regional lymph nodes • Tend to extensively spread into the adjacent neck spaces, ignoring normal fascial planes • Acute stage : Soft tissue swelling, painful pyogenic abscess, or mass lesion • Subacute to chronic stage : Painless indurated mass spreading to the skin, often accompanied by draining sinus tracts • Intermediate signal intensity relative to muscle on T1WI/T2WI |
| Correct answer |
Correct AnswerSemi-Correct Answer |