Unilateral Tonsillar Hypertrophy Masquerading as Malignant Neoplasm: Actinomycosis – The Culprit

Document Type : Case Report


1 Department of Pathology, UP University of Medical Sciences, Saifai, Etawah,

2 Department of Pathology, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India



Actinomycosis is an infrequent bacterial infection encountered nowadays, caused by anaerobic Gram‑negative bacterium of Actinomyces
species. We report an unusual case of a unilateral tonsillar hypertrophy in a 40‑year‑old male, caused by actinomycosis masquerading as
malignant tumor. To the best of our knowledge, only seven cases of actinomycosis causing unilateral tonsillar hypertrophy have previously
been published. Since this anaerobic organism is difficult to culture, the diagnosis is made by observing its associated sulfur granules in the
biopsy specimens. Still, actinomycosis represents an important entity in today’s context as it is the great masquerader of the head‑and‑neck
lesions because of its myriad presentation that may mimic other common diseases, the difficulties involved in its diagnosis, and the long course
of treatment mandatory to eradicate the disease.