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BMJ Case Reports 2012; doi:10.1136/bcr-2012-007084
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Laryngeal actinomycosis mimicking relapse of laryngeal carcinoma in a 67-year-old man

  1. Christian Chidiac1,2,3
  1. 1Service de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
  2. 2Université Claude Bernard Lyon 1, Lyon, France
  3. 3INSERM U851, Pathogénie Bactérienne et Immunité Innée, Lyon, France
  4. 4Service d'Oto-Rhino-Laryngologie, Hospices Civils de Lyon, Lyon, France
  1. Correspondence to Dr Tristan Ferry, tristan.ferry{at}univ-lyon1.fr

Description

A 67-year-old man, a heavy smoker with a history of myocardial infarction, was followed up for a T3N2M0 laryngeal carcinoma. After primary chemotherapy, lateral pharyngo-laryngectomy was performed, followed by radiotherapy. Two-years later, mild dyspnoea at rest appeared and a relapse was suspected, as an ulcerated lesion with oedema was detected during endoscopy (figure 1A). Pathological examination of biopsies revealed cartilage suppurative necrosis with sulphur granules (figure 1C) and filamentous Gram-positive fungal-like pathogen (figure …

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