Acute actinomycosis presenting as an ulcerated palatal mass

Actinomycosis is a relatively rare bacterial infection produced by a variety of commensal saprophytes that usually gain ingress to deeper tissues through disruption of the normal host defense mechanisms. Identified as the causative organisms of actinomycosis are A israelii, A naeslundii, A viscosus, A odontolyticus, A meyeri, and Proprionibacterium propionica. These organisms have a low-grade virulence and become pathologic depending on host susceptibility. Although the cervicofacial location is the most common anatomic area for actinomycosis, it may affect any site in the body. Dental disease, oral surgery, and trauma are all well-recognized potential antecedents of cervicofacial actinomycosis. Actinomycosis can mimic many other diseases, including neoplasms, and the diagnosis may be difficult even for experienced clinicians. This report describes a case of acute actinomycosis in a rare location, the anterior palate, in an individual who had no identifiable portal of entry.