Unilateral Tonsillar Hypertrophy Masquerading as Malignant Neoplasm: Actinomycosis – The Culprit

Actinomycosis is an infrequent bacterial infection encountered nowadays, caused by anaerobic Gram‑negative bacterium of Actinomyces species. We report an unusual case of a unilateral tonsillar hypertrophy in a 40‑year‑old male, caused by actinomycosis masquerading as malignant tumor. To the best of our knowledge, only seven cases of actinomycosis causing unilateral tonsillar hypertrophy have previously been published. Since this anaerobic organism is difficult to culture, the diagnosis is made by observing its associated sulfur granules in the biopsy specimens. Still, actinomycosis represents an important entity in today’s context as it is the great masquerader of the head‑and‑neck lesions because of its myriad presentation that may mimic other common diseases, the difficulties involved in its diagnosis, and the long course of treatment mandatory to eradicate the disease.