Background:
Actinomycosis is a granulomatous infection produced by filamentous, gram-positive anaerobic bacteria. Due to its rarity, ambiguous symptoms, and resemblance to more frequent disorders, including cancer, Crohn's disease, and tuberculosis, it is a challenging disease to identify preoperatively.
Case presentation:
Our case was a case of a 36-year-old woman from the Oromia region's West Arsi zone, who presented with a 6-month history of snoring, dysphonia, and cough, as well as significant but unquantified weight loss, fatigue, and low-grade and intermittent fever, for which she had visited various health facilities with no noticeable improvements in her symptoms. She has had diabetes for the past 5 years and is on Metformin 500 mg twice a day with poor glycemic control. The physical findings at the presentation, including the throat examination, were unremarkable. The random blood sugar level was 300 mg/dl at the time of presentation (elevated). Laryngoscopy revealed an irregular tumor on the anterior one-third of the vocal cord bilaterally, involving the anterior commissure. The biopsy result revealed actinomycotic granules with abscess formation. The patient was then started on Penicillin G, and there was a resolution of her symptoms during follow-up, and then on put on Amoxicillin for the next 6 months, which was discontinued when she had fully recovered from her symptoms and the mass had been cleared on follow-up laryngoscopy.
Conclusion:
Laryngeal actinomycosis closely resembles laryngeal cancer and other common inflammatory conditions like laryngeal tuberculosis. It is recommended that clinicians, particularly otolaryngologists, be aware of such rare but eerily similar disease conditions so that unnecessary interventions can be avoided on time.