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Mixed infection of Actinomyces israelii and Fusobacterium nucleatum presenting as a neck mass
  1. James Patrick King,
  2. Mili Dhar,
  3. Stephanie Jane Smith and
  4. Julian Emmanuel
  1. Surrey and Sussex Healthcare NHS Trust, Redhill, UK
  1. Correspondence to Dr James Patrick King; james.king16{at}


This report presents the case of a mixed infection of Actinomyces israelii and Fusobacterium nucleatum, presenting as an extensive neck mass progressing through tissue planes and causing bony destruction. Despite multiple abscess aspirates, imaging and serological investigations, the causative organisms proved elusive over the course of the patient’s long admission, only to be identified postdischarge. The patient was successfully initiated on a prolonged course of intravenous antibiotics and did not suffer from any complications. This report aims to raise awareness of the presentation, pathogenicity and treatment of Actinomyces and Fusobacteria infections, given a notable difficulty in diagnosis.

  • ear
  • nose and throat
  • infections
  • skin
  • infectious diseases

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  • Contributors All doctors were involved in the case, in both treatment, diagnosis and management of the patient. JPK and MD co-wrote the case report, while JE oversaw drafting and approving the final version. SJS aided with editing following submission of the first draft and reviewer comments.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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