Disguised and Dangerous: A Case of Cervicofacial Actinomycosis presenting with Hemoptysis

Actinomycosis is a rare, chronic, suppurative bacterial infection caused by <b><i>Actinomyces spp</i></b> with an incidence of 0.3 cases per million people annually. The cervicofacial area is the most common site of infection and accounts for approximately 50 percent of all cases. Most cases of cervicofacial actinomycosis are odontogenic in origin. Hemoptysis in the setting of actinomycosis commonly occurs from pulmonary involvement. Hemoptysis secondary to isolated cervicofacial actinomycosis has seldom been documented in literature. We hereby present a case of cervicofacial actinomycosis presenting with hemoptysis likely secondary to an oro-cervical fistula. We aim to highlight the challenges in diagnosis of this relatively rare clinical entity and the potential for life threatening complications if not detected and managed appropriately.