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Case Reports
. 2020 Jul-Dec;10(2):525-528.
doi: 10.4103/ams.ams_99_20. Epub 2020 Jun 23.

Actinomycotic Osteomyelitis of the Mandible - A Rare Case Report

Saurabh Sunil Simre  1 , Anendd A Jadhav  1 , Chirag S Patil  1
Affiliations
Case Reports

Actinomycotic Osteomyelitis of the Mandible - A Rare Case Report

Saurabh Sunil Simre et al. Ann Maxillofac Surg. 2020 Jul-Dec.

Abstract

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.

Keywords: Actinomycosis; filamentous; jaw infection; osteomyelitis; ray fungus; suppuration.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Intraoral view
Figure 2
Figure 2
(a) Preoperative orthopantomograph presenting an extensive ill-defined radiolucent lesion over the left side of the mandible (arrows). (b) Cone beam computed tomography presenting with mandibular osseous lesion and cortical erosion over the left side of the mandible (arrows). (c) Intraoperative clinical view depicting decortication and debridement of the left side of the mandible (arrows)
Figure 3
Figure 3
(a) Histopathology demonstrating filamentous actinomyces israelii colonies surrounded by inflammatory cells and necrotic material suggestive of acute suppurative osteomyelitis with actinomyces (Leishman staining, 40X) (arrows). (b) Postoperative 6 months follow-up radiograph showing resolution of infection and neo-bone formation (arrows)
See this image and copyright information in PMC

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