Aim and objective: To report a case of multiple epidermoid cysts of the tonsil with actinomycosis in a 56-year-old female patient who presented with discomfort in the throat. Background: The Actinomyces spp. are common saprophytic microorganisms, which are found in the oral cavity, pharynx, and palatine tonsils. The actinomycotic infections can be responsible for recurrent chronic tonsillitis. Epidermoid cysts are benign lesions that can be encountered anywhere in the body, usually seen in neck, chest, or trunk. Case description: This study reports a case of multiple epidermoid cysts of the tonsil with actinomycosis in a 56-year-old female patient presented to our ENT outpatient department with discomfort in the throat and presence of a few whitish masses over her right tonsil, which was her major concern. She underwent a tonsillectomy followed by a course of antibiotic for 3 weeks; the diagnosis was confirmed by histology. Conclusion: Though tonsillitis is the commonest lesion diagnosed in all age groups, histopathology plays an important role in diagnosis of various other non-neoplastic and neoplastic lesions of tonsil. There might be existence of two separate clinical entities in a single case, one being the causative factor of another. Clinical significance: Our results indicate that actinomycetes may play an active role in the etiology of the epidermoid cyst of the tonsillar tissue. The clinical importance of recognizing this organism lies in the fact that definitive treatment requires a long course of penicillin group antibiotics even after surgical excision. To the best of our knowledge, this is the first case report in the English-indexed literature.
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