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Chronic sinusitis unresponsive to medical therapy: a case of maxillary sinus actinomycosis focusing on computed tomography findings

¹ Department of Stomatology, Bauru Dental School, University of São Paulo, Brazil; ² Medical Pathology, Lauro de Souza Lima Hospital, Bauru, São Paulo, Brazil

*Correspondence to: José Humberto Damante, Al. Dr. Octávio Pinheiro Brisolla, 9-75 – Faculdade de Odontologia de Bauru – Departamento de Estomatologia, Vila Universitária – Bauru - SP, Cep: 17012-901, Brazil; Email: damante{at}fob.usp.br

Received 25 January 2005; revised 27 July 2005; accepted 1 September 2005

Actinomycosis of the paranasal sinuses is a rare occurrence and its clinical presentation does not suggest a specific diagnosis. Therefore, actinomycosis should be included in the differential diagnosis of neoplasms and granulomatous lesions of the head and neck region. However, the differentiation from a malignant neoplasm is not easy because the radiological findings are frequently similar and positive cultures are difficult to obtain. This report highlights the clinical progress of paranasal actinomycosis associated with some computed tomography findings that can be extremely helpful in the correct diagnosis. The characteristics of the disease are described and the relevant literature is discussed.

Keywords: sinusitis; infection; actinomycosis; paranasal sinus neoplasm; tomography; X-ray computed