A 32-year-old man comes to the office due to 2 months of increase neck swelling under his right jaw. The swelling hasn't improved despite it was opened and drained pus a month ago. The patient has no medical conditions other than dental caries; he had a tooth extracted prior to symptom onset. Physical examination shows an indurated, nontender mass in the rightt submandibular area with a small opening on the overlying skin. Gentle pressure on the mass yields thick pus containing sand/grain-like particles. The microbial pathogen with which of the following characteristics is the most likely cause of this patient's condition?

Question

A 32-year-old man comes to the office due to 2 months of increase neck swelling under his right jaw.  The swelling hasn't improved despite it was opened and drained pus a month ago. The patient has no medical conditions other than dental caries; he had a tooth extracted prior to symptom onset.  Physical examination shows an indurated, nontender mass in the rightt submandibular area with a small opening on the overlying skin.  Gentle pressure on the mass yields thick pus containing sand/grain-like particles.  The microbial pathogen with which of the following characteristics is the most likely cause of this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: Actinomyces species are gram-positive, branching, filamentous bacteria that may cause cervicofacial infections when introduced to the submucosa during mechanical trauma (eg, tooth extraction).  Manifestations include a slowly enlarging, nonpainful, chronic mandibular mass that evolves into multiple abscesses and sinus tracts draining yellow-orange sulfur granules.

A 32-Year-Old Man Comes to the Office Due to 2