Actinomycosis mimicking a tonsillar neoplasm in an elderly diabetic patient

Actinomycosis is a slowly progressive infection that can occur anywhere in the body. Three distinct clinical entities are described: cervico-facial, abdomino-pelvic and thoracopulmonary. Actinomyces are anaerobic, gram positive, non-acid-fast, branched filamentous bacteria that form part of the normal oral, colonic and vaginal flora of humans. The cervico-facial form of the disease is commonest and results from direct invasion of commensal oral actinomyces into local tissues. The most frequently isolated species is A. israelii. We describe a case where Actinomycosis caused massive unilateral hypertrophy of the tonsil, mimicking neoplasia. This is an unusual presentation of Actinomycosis.