Actinomyces Odontolyticus with Klebsiella and Bacteroides Presenting as Facio-Cervical Abscess with Extension to Scalp and no Sinus Tract

Actinomycosis is a rare infectious bacterial disease caused by various Actinomyces species. Being very rare, Actinomyces is easily misdiagnosed. Actinomyces are common commensals of the oral cavity which predispose to local infections. We report a case of a 67-year-old female who initially presented with swelling of the left sided face which later on proved to be a mixed infection with actinomycosis. CT imaging of head and neck was done, which revealed an abscess over the cervicofacial region. The abscess was drained and the pus was cultured in aerobic and anaerobic medium. Cultures grew actinomycosis with superadded Bacteroides and Klebsiella. The patient was managed with incision and drainage, as well as ceftriaxone. Actinomycosis is a rare infection in cervicofacial region, however, we should keep our differentials open always. Both clinical and microbiological diagnosis avoids serious errors in diagnosis.