Head and neck tumours: cervicofacial actinomycosis: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Head and neck tumours: cervicofacial actinomycosis

Sample item

After a dental extraction a man develops a hard swelling at the angle of the mandible that breaks down into multiple sinuses discharging yellow granules. Which treatment is most appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Prolonged high-dose penicillin with surgical drainage

Cervicofacial actinomycosis is caused by the anaerobic Gram-positive filamentous bacterium Actinomyces israelii, which causes chronic suppuration with sulphur granules and draining sinuses. Treatment is penicillin for many weeks, with drainage of abscesses. It is a bacterial and not a fungal infection.

Option by option

  • A. Systemic antifungal therapy

    Actinomyces is a bacterium and does not respond to antifungal drugs.

  • B. Antitubercular therapy for 6 months

    Tuberculosis causes cold abscess and scrofula with caseation but not sulphur granules.

  • C. Prolonged high-dose penicillin with surgical drainage (correct)

    Correct. Long courses of penicillin plus drainage are standard.

  • D. A single dose of ciprofloxacin

    A short single dose fails to cure a chronic anaerobic infection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Prolonged high-dose penicillin with surgical drainage. Cervicofacial actinomycosis is caused by the anaerobic Gram-positive filamentous bacterium Actinomyces israelii, which causes chronic suppuration with sulphur granules and draining sinuses.

Why is "Systemic antifungal therapy" not the answer?

Actinomyces is a bacterium and does not respond to antifungal drugs.

Why is "Antitubercular therapy for 6 months" not the answer?

Tuberculosis causes cold abscess and scrofula with caseation but not sulphur granules.

Why is "A single dose of ciprofloxacin" not the answer?

A short single dose fails to cure a chronic anaerobic infection.

What concept does this question test?

It tests Head and neck tumours: cervicofacial actinomycosis in ENT. Treatment is penicillin for many weeks, with drainage of abscesses. It is a bacterial and not a fungal infection.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck tumours: cervicofacial actinomycosis?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.