Skip to main content
Log in

The contribution of histopathological examination to the diagnosis of cervico-facial actinomycosis: a retrospective analysis of 68 cases

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript


Cervico-facial actinomycosis is an infectious, suppurative, and granulomatous disease due to Actinomyces species. Usually, the diagnosis is confirmed by microbiological cultures; however, the need for careful anaerobic handling of specimens often makes it difficult to obtain an effective microbial growth. Therefore, we conducted a retrospective study on biopsy samples from patients with a clinical suspicion of cervico-facial actinomycosis, in order to determine whether accurate histopathological examination could reliably confirm the diagnosis. A retrospective revision of formalin-fixed, paraffin-embedded archival material from 68 cases of cervico-facial lesions, with negative culture for anaerobic/microaerophilic microorganisms, was performed. Twelve serial sections for each case were cut from the paraffin blocks, individually collected on positively charged slides to obtain good section-to-slide adhesion, and stained with hematoxylin and eosin (H&E) and periodic acid–Schiff (PAS). Histopathological examination of the serial sections allowed the identification of bacterial colonies consistent with actinomycetes in 22 cases (32 %). The proposed histopathological examination allowed the retrospective diagnosis of cervical actinomycosis in one-third of clinical specimens that remained misdiagnosed following traditional H&E examination.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Nagler R, Peled M, Laufer D (1997) Cervicofacial actinomycosis: a diagnostic challenge. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83(6):652–656

    Article  PubMed  CAS  Google Scholar 

  2. Bennhoff DF (1984) Actinomycosis: diagnostic and therapeutic considerations and a review of 32 cases. Laryngoscope 94(9):1198–1217

    Article  PubMed  CAS  Google Scholar 

  3. Oostman O, Smego RA (2005) Cervicofacial actinomycosis: diagnosis and management. Curr Infect Dis Rep 7(3):170–174

    Article  PubMed  Google Scholar 

  4. Volante M, Contucci AM, Fantoni M, Ricci R, Galli J (2005) Cervicofacial actinomycosis: still a difficult differential diagnosis. Acta Otorhinolaryngol Ital 25(2):116–119

    PubMed  CAS  PubMed Central  Google Scholar 

  5. Stenhouse D (1975) Intraoral actinomycosis. Report of five cases. Oral Surg Oral Med Oral Pathol 39(4):547–552

    Article  PubMed  CAS  Google Scholar 

  6. Stenhouse D, MacDonald DG, MacFarlane TW (1975) Cervico-facial and intra-oral actinomycosis: a 5-year retrospective study. Br J Oral Surg 13(2):172–182

    Article  PubMed  CAS  Google Scholar 

  7. Moghimi M, Salentijn E, Debets-Ossenkop Y, Karagozoglu KH, Forouzanfar T (2013) Treatment of Cervicofacial Actinomycosis: a report of 19 cases and review of literature. Med Oral Patol Oral Cir Bucal 18(4):e627–e632

    Article  PubMed  PubMed Central  Google Scholar 

  8. Pradhan S, Datta NR, Prasad KN, Ayyagari S, Pandey R (1993) Actinomycosis mimicking carcinoma of the maxillary sinus. Indian J Cancer 30(1):1–4

    PubMed  CAS  Google Scholar 

  9. Rubin MM, Krost BS (1995) Actinomycosis presenting as a midline palatal defect. J Oral Maxillofac Surg 53(6):701–703

    Article  PubMed  CAS  Google Scholar 

  10. Belmont MJ, Behar PM, Wax MK (1999) Atypical presentations of actinomycosis. Head Neck 21(3):264–268

    Article  PubMed  CAS  Google Scholar 

  11. Appiah-Anane S, Tickle M (1995) Actinomycosis—an unusual presentation. Br J Oral Maxillofac Surg 33(4):248–249

    Article  PubMed  CAS  Google Scholar 

  12. Oppenheimer S, Miller GS, Knopf K, Blechman H (1978) Periapical actinomycosis. An unusual case report. Oral Surg Oral Med Oral Pathol 46(1):101–106

    Article  PubMed  CAS  Google Scholar 

  13. Aguirrebengoa K, Romaña M, López L, Martín J, Montejo M, González De Zárate P (2002) Oral and cervicofacial actinomycosis. Presentation of five cases. Enferm Infect Microbiol Clin 20(2):53–56

  14. Myerovitz RL (1983) The pathology of opportunistic infections, 1st edn. Raven Press, New York

    Google Scholar 

  15. Laskaris G (1996) Oral manifestations of infectious diseases. Dent Clin North Am 40(2):395–423

    PubMed  CAS  Google Scholar 

  16. Kaya D, Demirezen Ş, Hasçelik G, Gülmez Kivanç D, Beksaç MS (2013) Comparison of PCR, culturing and Pap smear microscopy for accurate diagnosis of genital Actinomyces. J Med Microbiol 62(Pt 5):727–733

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to E. Maiorano.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lo Muzio, L., Favia, G., Lacaita, M. et al. The contribution of histopathological examination to the diagnosis of cervico-facial actinomycosis: a retrospective analysis of 68 cases. Eur J Clin Microbiol Infect Dis 33, 1915–1918 (2014).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: