{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:56:27Z","timestamp":1775843787054,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Cervicofacial actinomycosis is an uncommon chronic bacterial infection that can mimic neoplasia or granulomatous disease because of its infiltrative presentation. Diagnosis is often delayed, particularly in pregnant patients in whom imaging and invasive procedures may be limited. Case report: A 25-year-old woman at 14 weeks of gestation presented with a multiple-fistulized cervical mass. The lesion was initially diagnosed as a cutaneous furuncle in a private dermatology practice and treated with topical therapy, resulting in only transient improvement. Two weeks later, multiple fistulizations developed, prompting consultation in the emergency department. ENT assessment and ultrasound raised suspicion of cervical actinomycosis versus fistulized tuberculous lymphadenitis. Considering the pregnancy, drainage of the collection was performed under local anesthesia and empiric antibiotic therapy with amoxicilin-clavulanic acid was started. Microbiological confirmation of Actinomyces (Schaalia) georgiae led to infectious disease evaluation that established a long-term antibiotic therapy while monitoring fetal safety. Progressive clinical improvement was observed, with complete resolution after three months. The pregnancy progressed without complications and fetal morphology remained normal under therapy. Conclusions: This case illustrates the diagnostic complexity of cervicofacial actinomycosis caused by A. georgiae during pregnancy, representing the first such report in the current literature, and emphasizes the need for a multidisciplinary approach.<\/jats:p>","DOI":"10.3390\/diagnostics16081140","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:05:51Z","timestamp":1775840751000},"page":"1140","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cervicofacial Actinomycosis Presenting as a Fistulized Neck Mass During Pregnancy: A Case Report"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9362-2030","authenticated-orcid":false,"given":"Florentina","family":"Severin","sequence":"first","affiliation":[{"name":"ENT Department, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei Alexandru","family":"Andoni","sequence":"additional","affiliation":[{"name":"Surgery Department, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9058-6070","authenticated-orcid":false,"given":"Raluca Ioana","family":"Serban","sequence":"additional","affiliation":[{"name":"Microbiology Department, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1423-3820","authenticated-orcid":false,"given":"Andrei","family":"Nicolau","sequence":"additional","affiliation":[{"name":"Oral and Maxillo-Facial Surgery Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7339-0443","authenticated-orcid":false,"given":"Deniss Vasile","family":"Mereuta","sequence":"additional","affiliation":[{"name":"Anatomy Department, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea","family":"Vlad","sequence":"additional","affiliation":[{"name":"ENT Department, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florin","family":"Mocanu","sequence":"additional","affiliation":[{"name":"ENT Department, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ionut Andrei","family":"Roman","sequence":"additional","affiliation":[{"name":"ENT Department, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3002-7530","authenticated-orcid":false,"given":"Octavian Dragos","family":"Palade","sequence":"additional","affiliation":[{"name":"ENT Department, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.2217\/fmb.14.130","article-title":"Actinomycosis: A frequently forgotten disease","volume":"10","author":"Boyanova","year":"2015","journal-title":"Future Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Gajd\u00e1cs, M., Urb\u00e1n, E., and Terhes, G. (2019). Microbiological and clinical aspects of cervicofacial actinomyces infections: An overview. Dent. J., 7.","DOI":"10.3390\/dj7030085"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"102767","DOI":"10.1016\/j.anaerobe.2023.102767","article-title":"The role of Actinomyces spp. and related organisms in cervicofacial infections: Pathomechanism, diagnosis and therapeutic aspects","volume":"82","author":"Nordskag","year":"2023","journal-title":"Anaerobe"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1002\/(SICI)1097-0347(199905)21:3<264::AID-HED12>3.0.CO;2-Y","article-title":"Atypical presentations of actinomycosis","volume":"21","author":"Belmont","year":"1999","journal-title":"Head Neck"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"361","DOI":"10.4103\/ams.ams_176_18","article-title":"Cervicofacial actinomycosis and its management","volume":"8","author":"Moturi","year":"2018","journal-title":"Ann. Maxillofac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1002\/lary.23477","article-title":"Invasive sinonasal actinomycosis: Case report and literature review","volume":"123","author":"Vorasubin","year":"2013","journal-title":"Laryngoscope"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1097\/OGX.0000000000000423","article-title":"Actinomyces in pregnancy: A review of the literature","volume":"72","author":"Estrada","year":"2017","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1099\/00221287-91-1-17","article-title":"Numerical taxonomy and laboratory identification of Actinomyces and Arachnia and some related bacteria","volume":"91","author":"Holmberg","year":"1975","journal-title":"J. Gen. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1099\/00207713-40-3-273","article-title":"Actinomyces georgiae sp. nov., Actinomyces gerencseriae sp. nov., designation of two genospecies of Actinomyces naeslundii, and inclusion of A. naeslundii serotypes II and III and Actinomyces viscosus serotype II in A. naeslundii genospecies 2","volume":"40","author":"Johnson","year":"1990","journal-title":"Int. J. Syst. Bacteriol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Zijnge, V., van Leeuwen, M.B.M., Degener, J.E., Abbas, F., Thurnheer, T., Gm\u00fcr, R., and Harmsen, H.J.M. (2010). Oral biofilm architecture on natural teeth. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0009321"},{"key":"ref_11","unstructured":"Mandell, G.L., Bennett, J.E., and Dolin, R. (2009). Agents of actinomycosis. Principles and Practice in Infectious Diseases, Elsevier. [7th ed.]."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1128\/CMR.00100-14","article-title":"Actinomyces and related organisms in human infections","volume":"28","author":"Wade","year":"2015","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Wong, V.K., Turmezei, T.D., and Weston, V.C. (2011). Actinomycosis. BMJ, 343.","DOI":"10.1136\/bmj.d6099"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1086\/376621","article-title":"Human cervicofacial actinomycoses: Microbiological data for 1997 cases","volume":"37","author":"Pulverer","year":"2003","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","first-page":"80","article-title":"Actinomyces Lymphadenitis: Case Report","volume":"29","year":"2013","journal-title":"Turk. Patoloji Derg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1086\/600885","article-title":"Ongoing revolution in bacteriology: Routine identification of bacteria by matrix-assisted laser desorption ionization time-of-flight mass spectrometry","volume":"49","author":"Seng","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1007\/s10096-011-1496-3","article-title":"Comparison of phenotypic methods and matrix-assisted laser desorption ionisation time-of-flight mass spectrometry for the identification of aero-tolerant Actinomyces spp. isolated from soft-tissue infections","volume":"31","author":"Ng","year":"2012","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/S1079-2104(97)90313-9","article-title":"Cervicofacial actinomycosis: A diagnostic challenge","volume":"83","author":"Nagler","year":"1997","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Shah, K.M., Karagir, A., Kanitkar, S., and Koppikar, R. (2013). An atypical form of cervicofacial actinomycosis treated with short but intensive antibiotic regimen. BMJ Case Rep., 2013.","DOI":"10.1136\/bcr-2013-008733"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1097\/SMJ.0b013e3181864c1f","article-title":"Actinomycosis: Diagnosis and management","volume":"101","author":"Brook","year":"2008","journal-title":"South Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Jain, A., Narula, V., Alam, K., and Shukla, I. (2013). Cervicofacial actinomycosis mimicking sebaceous cyst. BMJ Case Rep., 2013.","DOI":"10.1136\/bcr-2012-008429"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2289","DOI":"10.1007\/s12070-023-03498-7","article-title":"Rare Case of Submandibular Actinomycosis","volume":"75","author":"Bajpai","year":"2023","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/S0033-8389(05)70214-1","article-title":"CT and MR imaging evaluation of neck, infections with clinical correlations","volume":"38","author":"Weber","year":"2000","journal-title":"Radiol. Clin. N. Am."},{"key":"ref_24","first-page":"331","article-title":"Cervicofacial Actinomycosis: CT and MR Imaging Findings in Seven Patients","volume":"24","author":"Park","year":"2003","journal-title":"Am. J. Neuroradiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Matsuda, S., Yoshida, H., and Yoshimura, H. (2021). Orofacial Soft Tissues Actinomycosis: A Retrospective, 10-Year Single-Institution Experience; 2020 Association for Dental Sciences of the Republic of China, Elsevier, B.V.","DOI":"10.1016\/j.jds.2020.01.003"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3070","DOI":"10.52768\/2766-7820\/3070","article-title":"Actinomycosis: A benign infection with aggressive behavior about 16 cases","volume":"5","author":"Maadane","year":"2024","journal-title":"J. Clin. Images Med. Case Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1086\/381099","article-title":"Short-term treatment of actinomycosis: Two cases and a review","volume":"38","author":"Sudhakar","year":"2004","journal-title":"Clin. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e627","DOI":"10.4317\/medoral.19124","article-title":"Treatment of actinomycosis A report of 19 cases and review of literature","volume":"18","author":"Moghimi","year":"2013","journal-title":"Med. Oral Patol. Oral Cir. Bucal"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/8\/1140\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:07:26Z","timestamp":1775840846000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/8\/1140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":28,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["diagnostics16081140"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16081140","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]}}}