Actinomycetes are a relatively sporadic cause of infection of the head-and-neck region and their appearance is usually uncharacteristic, and hence pose a challenge for the diagnosis. The present article intends to exhibit this rarity afflicting mandible and highlight its management. The present report describes a case of a 55-year-old countryside female who presented with pain and swelling affecting the left side of the mandible. Orthopantomograph and cone-beam computed tomography imaging showed multiple ill-defined radiolucencies and perforations of the buccal and lingual cortical plates. Fine-needle aspiration microbiology was used to ascertain the microbial organism and the patient was treated with amoxicillin + clavulanic acid with curettage of the infected site. The patient responded well to prompt systemic antibiotics and local surgical measures with complete resolution of the infection and spontaneous bone regeneration. Although rare actinomycosis of the mandible is curable and should be included in the differential diagnosis of osteomyelitis of the jaw. Early and accurate diagnosis and prompt intervention confirm better outcomes.
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http://dx.doi.org/10.4103/ams.ams_99_20 | DOI Listing |
Case Rep Dent
January 2025
Department of Dental, Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria.
Actinomycosis is a rare chronic granulomatous infection and can be caused by Gram-positive anaerobic bacteria which are normal commensals of the oral cavity and pharynx. These organisms can involve different parts of the maxillofacial region, rarely affecting the jaws. Actinomycotic osteomyelitis is an infection of the jaw bones, typically associated with trauma or an underlying nonspecific infection or disease.
View Article and Find Full Text PDFBMJ Case Rep
November 2024
Infectious Diseases, Kasturba Medical College Manipal, Manipal, Karnataka, India.
Mycetoma of the hand is a chronic granulomatous disease seen in the tropics and subtropical regions, mainly affecting the skin and subcutaneous tissue of the foot. Primary actinomycotic osteomyelitis involving the metacarpals is rarely reported in the literature. The conventional treatment for actinomycosis has been high-dose penicillin.
View Article and Find Full Text PDFAm J Med Sci
August 2024
Department of Pathology, Microbiology Laboratory, Tripler Army Medical Center, Honolulu, HI, United States. Electronic address:
This case report presents an unusual occurrence of Winkia (Actinomyces) neuii vertebral osteomyelitis in a 55-year-old male patient with diabetes mellitus. W. neuii is a distinct species formerly placed within the Actinomyces genus, exhibiting unique morphological and clinical characteristics.
View Article and Find Full Text PDFClin Adv Periodontics
June 2024
Department of Periodontics, Virginia Commonwealth University School of Dentistry, Richmond, Virginia, USA.
Background: Actinomycosis can be caused by periapical endodontic infection, trauma, or surgical dental procedures. Due to its rare occurrence in a healthy adult patient, persistent actinomycotic osteomyelitis around implants presenting as severe peri-implantitis may be challenging to diagnose.
Methods: A 26-year-old male patient with non-contributory medical history presented to the Oral and Maxillofacial Surgery Clinic in 2018 with pain and edema associated with endodontically treated maxillary premolar teeth with poor prognosis.
J Maxillofac Oral Surg
April 2024
Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Lesserstraße 180, 22049 Hamburg, Germany.
Background: Osteomyelitis is a serious entity that can occur in many different locations. Especially in the mandible, osteomyelitis can show different clinical courses, which differ clearly from other anatomical regions in terms of severity and treatment. Osteomyelitis in the mandible is often caused by mixed species of the oral cavity.
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