Unusual case of resistant actinomycosis following facial trauma.

A case of actinomycosis is reported which appeared as a complication of a ski-pole injury of the face. A 16-year-old girl was treated for 10 years for resistant actinomycosis. She took long-term antimicrobial therapies, underwent repeated excisions, hyperbaric oxygen therapy, repeated skin grafting, immunological treatment, and free flap transfer. The conservative antibiotic treatment was complicated by mycosis and pseudomembranous colitis. After the defect healed up, satisfactory contour of the face was restored with additional free flap transfer. The patient has also been satisfied with the final aesthetic result. The authors highlight the importance of early diagnosis and proper antimicrobial treatment in combination with surgical excisions of granulation tissue preserving vital structures.