Carotid artery rupture and cervicofacial actinomycosis

Article Article scientifique Article Carotid artery rupture and cervicofacial actinomycosis eng 2012 author Kummer Anne-Karin 32714 author Lhermitte Benoît author Ödman Micaela author Grabherr Silke 746290 author Mangin Patrice 662095 author Palmiere Cristian 534288 324-327 10.1016/j.legalmed.2012.06.002 22819527 1344-6223 Cervicofacial actinomycosis is an uncommon, progressive infection caused by bacilli of the Actinomyces genus. Actinomyces are common commensal saprophytes in the oral cavity which may have medical importance as facultative pathogens. Subsequent to local injuries to the oral mucosa, they may penetrate the deep tissues and be responsible for suppurative or granulomatous infections. We herein report a case of a 65-year-old man who underwent surgery followed by chemotherapy and radiotherapy for a tonsillar carcinoma. An ulcerous lesion in the base of the tongue developed and spread to the carotid artery wall. The man died of a massive hemorrhage due to left carotid artery rupture. Postmortem computed tomography angiography performed prior to autopsy allowed the precise localization of the source of bleeding to be detected. Postmortem biochemical investigations confirmed the presence of inflammation associated with local bacterial infection. Histological investigations revealed the rupture of the left carotid artery surrounded by numerous colonies of Actinomyces. Acute and chronic inflammation with tissue necrosis as well as post-actinic, fibrotic changes were also found in the tissues surrounding the ruptured artery wall. Actinomycosis, Cervicofacial/complications Aged Angiography Autopsy/methods Carcinoma, Squamous Cell/microbiology/surgery Carotid Artery Injuries/complications/etiology/microbiology Fatal Outcome Hemorrhage/etiology Humans Male Postoperative Complications/etiology/microbiology Rupture, Spontaneous/complications/etiology/microbiology Tomography, X-Ray Computed Tonsillar Neoplasms/microbiology/surgery Trismus/etiology Dewey 614.1 67 Institut de médecine légale 22A2 false 959 Groupe Silke Grabherr 969 Legal Medicine 14 6 f2cf54c9-4810-4cad-b83d-3639e56903f0 Article (Published version) Restricted 1-s2.0-S1344622312001034-main.pdf 553965 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de médecine légale

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Carotid artery rupture and cervicofacial actinomycosis	Legal Medicine			2012	390	0

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Kummer, Anne-Karin