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Background: Actinomyces odontolyticus is a grampositive, anaerobic bacteria that is part of the normal oral commensal flora. It has been previously demonstrated to be a rare cause of endogenous bacterial infections in humans. In the current case report, we present a rare case of vocal cord infection caused by Actinomyces odontolyticus after injection laryngoplasty with Deflux in an otherwise healthy male patient. Case presentation: A 61-year-old healthy male was taken to the operating theater for injection laryngoplasty for agerelated bilateral vocal cord atrophy. He had previously tolerated a short-acting injectable with favourable results and was interested in trying Deflux, a longer-lasting dextranomer/hyaluronic derivative with documented success in Urology literature, but which hasn’t been routinely used in the airway. Three days after the procedure, the patient presented to clinic with worsening hoarseness and stridor. Nasopharyngoscopy demonstrated profuse, but distinctly unilateral left supraglottic and glottic edema, despite bilateral injection. It was initially treated conservatively with oral prednisone and antibiotics. Although the supraglottic edema resolved, the patient had persistent inflammation and edema of the left vocal cord. He was taken to the operating theater for surgical exploration, where incision and drainage yielded thick, purulent discharge. Final cultures grew Actinomyces odontolyticus. Following surgery, the left vocal cord healed well, but had persistent hypomobility and decreased pliability of the mucosal cover secondary to scarring from the infection. Conclusion: Infection with Actinomyces is a rare clinical entity with few reports of laryngeal involvement in the literature. This case highlights the unique diagnostic challenge of vocal cord infection and prompts consideration and recognition of Actinomyces as a potential etiology.

A Rare Case of Actinomyces odontolyticus Infection after Injection Laryngoplasty with Deflux