A Case of Cervical Actinomycosis Involving Penicillin Allergy

We report a case of actinomycosis involving penicillin allergy. A 39-year-old man was referred to us with left upper neck mass with tenderness. After antibiotic therapy, the neck mass was surgically excised under general anesthesia. The pathological diagnosis was actinomycosis. Due to his penicillin allergy, the man was administered clarithromycin for three months after surgery. No recurrence has occurred in the 2 years since treatment. The incidence of symptomatic actinomycosis, an unusual chronic infectious granulomatous disease caused by the anaerobic gram-positive bacterium Actinomyces israelii, has decreased as antibiotics use has spread. Because actinomycosis commonly appears as a pseudotumor mass, it must be differentiated from other tumors, particularly malignancies. Almost all actinomycosis require long-term penicillin therapy. Our case demonstrates an alternative to penicillin for those with actinomycosis but allergic to penicillin.