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Fundamento La actinomicosis es una enfermedad infecciosa de tipo supurativo y granulomatoso de evolucion cronica, causada por Actinomyces sp. y que afecta con mayor frecuencia al area cervicofacial. Objetivo Estudiar las caracteristicas de los pacientes con actinomicosis, en cuanto a antecedentes clinicos, presentacion clinica, metodo diagnostico, tratamiento y seguimiento. Pacientes y metodo Se ha realizado una revision retrospectiva de los casos de actinomicosis orocervicofacial microbiologica o anatomopatologicamente probados. Resultado Se estudian 5 pacientes, 2 varones y 3 mujeres, de edades comprendidas entre 25-69 anos. Cuatro pacientes tenian antecedentes de intervenciones quirurgicas y/o manipulaciones dentarias. Tres pacientes tenian la presentacion clasica de bultoma y fistulizacion y dos presentaban lesiones intraorales. En 4 enfermos se obtuvo un diagnostico microbiologico con cultivo positivo para A. israelii, y en el paciente restante mediante la citologia de un grano de azufre. Solamente la primera paciente recibio la pauta clasica de penicilina i.v., tres fueron tratados con cefalosporinas de tercera generacion, continuada posteriormente con amoxicilina oral durante 12 meses. La paciente 2 preciso una segunda intervencion quirurgica. El paciente 5, con un cuadro exclusivo intraoral, recibio una pauta corta de amoxicilina. No se han encontrado recidivas en el seguimiento. Conclusion La actinomicosis es una enfermedad infrecuente. Se precisa un elevado indice de sospecha y una buena colaboracion clinicomicrobiologica para poder obtener un diagnostico definitivo. La pauta clasica de penicilina i.v. y amoxicilina oral durante 6-12 meses es eficaz. La fase aguda del tratamiento con penicilina i.v. puede ser sustituida por cefalosporinas de tercera generacion.

Actinomycosis is a suppurative and granulomatous chronic infectious disease caused by Actinomyces sp. and most commonly affecting the cervicofacial area.To study the clinical characteristics of patients with actinomycosis, with regard to clinical history, presentation, method of diagnosis, treatment and follow up.A retrospective review was performed on all cases of microbiologically or histologically proven oral or cervicofacial actinomycosis.Five patients were studied, 2 men and 3 women, 25-69 years old. Four patients had a history of surgical procedures and/or dental manipulations. Three patients showed the classic presentation of a lump and fistulization, and two patients presented intra-oral lesions. Four patients were diagnosed by cultures positive to A. israelii on microbiologic study and the remaining patient by cytologic detection of a sulfur granule. The first patient received the classic initial regimen of iv penicillin and 3 were treated with third-generation cephalosporins, continuing with oral amoxicillin during 12 months. Patient no.2 required a second surgical procedure. Patient no. 5, who had an exclusively oral process, received a short course of amoxicillin. There were no relapses during follow-up.Actinomycosis is an uncommon disease. Establishment of the definite diagnosis requires a high index of suspicion and good clinical-microbiological collaboration. The classic course of iv penicillin and oral amoxicillin during 6-12 months is effective. For the acute phase treatment, iv penicillin can be replaced by third-generation cephalosporins.