Cervical Facial Actinomycosis Complicated by Bacteremia After 30 Years of Dental Neglect: Successful Treatment With Ceftriaxone and Metronidazole.

Actinomycosis is an uncommon bacterial infection, caused by the Actinomyces species, and it most commonly presents as cervicofacial actinomycosis. The most common risk factors for actinomycosis are poor dental hygiene, oral surgery, maxillofacial trauma, local tissue inflammation, and diabetes. We discuss a case of a male patient in his 50s with 30 years of poor dental hygiene, complicated by tobacco use, who presented with septic shock and was found to have cervicofacial actinomycosis and bacteremia. The treatment of severe actinomycosis often involves prolonged penicillin-based antibiotic therapy. This is the first case in the literature to describe the successful treatment of cervicofacial actinomycosis and bacteremia with intravenous cefepime (later narrowed to ceftriaxone) and oral metronidazole.