Actinomyces of the Hard Palate Presenting as Acute Sinusitis

Actinomyces-related osteomyelitis of the face and jaw is an uncommon complication following invasive dental procedures or trauma, but can have an idiopathic etiology. This case involved a 71-year-old woman who presented to her primary physician for acute sinusitis over a two-week period. CT scan revealed sinusitis with associated bony destruction of the hard palate. She was subsequently referred over concern for invasive fungal sinusitis. She underwent biopsy and debridement yielding a diagnosis of Actinomycesrelated osteomyelitis of the hard palate. Debridement and intense antimicrobial therapy for several months eventually resolved her infection. Though her outcome was favorable, patients with this disease can present after this invasive and aggressive bacteria has already caused irreversible damage.