Prokinetic drugs in the upper gastrointestinal tract - the past and the present Prokinetyki w górnym odcinku przewodu pokarmowego - przesz o i tera niejszo

Actinomycosis is a rare infectious disease caused by Gram(+) bacteria of the genus Actinomyces or mixed infections with their contribution. Actinomycetes belong to endogenous mouth flora. The development of the infection requires specific circumstances e.g. malnutrition, alcoholism, radiotherapy, diabetes, dental caries, dental extractions or immune deficiency. Cervicofacial actinomycosis is a chronic disease characterized by abscess formation, draining sinus tracts, fistulae, and tissue fibrosis. We present a case of a 16-year-old boy with typical cervicofacial actinomycosis. The predisposing factor was the extensive dental caries. The diagnosis was made 4 months after the first symptoms by culturing of Actinomyces meyeri from the cervical abscess. The boy was ineffectively treated with multiple antibiotics, eventually combined therapy with penicillin and clindamycin resolved the symptoms. Acitinomycosis should be included in the differential diagnosis of any soft tissue swelling in the head and neck, particulary complicated by abscess and fistulae formation. Actinmomycosis is usually a mixed infection requiring combined antibiotic therapy.