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DOI: 10.48087/BJMS.2026.130323
Authors: Samia BICHA 1,2,3 , Nadim ABDELMOUMEN4
Affiliations: 1- Constantine 3 University. 2- Research Laboratory LR2M. 3- Pediatrics Department B, Constantine University Hospital Center. 4-Pathological Anatomy Laboratory, Constantine University Hospital Center – Algeria.
Abstract
Cervicofacial actinomycosis is a rare bacterial infection in children that often presents with nonspecific symptoms mimicking malignancy or other inflammatory processes, posing significant diagnostic challenges. We report the case of a 3-year-old boy who presented with a one-month history of a painless, firm, immobile 10 cm mass on the left side of his neck, following a brief febrile episode. Physical examination revealed a hard, non-tender mass fixed to deep structures with associated satellite lymphadenopathy, while the oral cavity appeared normal. Initial inflammatory markers were unremarkable, and bacteriological analysis of the ultrasound-guided biopsy was negative, likely due to prior antibiotic exposure and suboptimal anaerobic culture conditions. Cervical computed tomography demonstrated a heterogeneous mass infiltrating adjacent muscles. The diagnosis was ultimately confirmed by histopathological examination, which revealed a mixed inflammatory infiltrate with granulomatous features and characteristic actinomyces grains. The patient was successfully treated with a 21-day course of intravenous ceftriaxone — owing to a documented penicillin allergy — followed by oral antibiotic therapy, for a total treatment duration of six weeks, resulting in complete resolution of the lesion. This case underscores the importance of maintaining a high index of suspicion for cervicofacial actinomycosis in children presenting with persistent cervical masses, particularly in the context of a preceding febrile episode. It further highlights that a multidisciplinary approach integrating clinical assessment, imaging, and histopathology is essential for timely diagnosis and effective management.
Keywords: Actinomycosis, Cervicofacial, Neck Mass, Children, and Diagnosis.