Actinomyces-induced Osteomyelitis of the Mandible - A Rare Disease?


Cite item

Full Text

Abstract

Background:Actinomyces species are commensal oral cavity flora that can cause jaw osteomyelitis. Osteomyelitis of the jaw by Actinomyces is rare, and its presentation can be confused with many different pathologies.

Case presentation:This is the case of a 61-year-old female with breast cancer and on chemotherapy as well as non-invasive carcinoma of the tongue who initially presented to the dentist with white spots in the right mandible near the incisors associated with right mandible pain and swelling. Actinomyces-induced osteomyelitis of the mandible was diagnosed. The patient was treated with penicillin V for 6 weeks along with a course of hyperbaric oxygen therapy, which resulted in the complete resolution of the infection.

Conclusion:In summary, jaw osteomyelitis caused by Actinomyces should always be part of the differential diagnosis; as these organisms are commensal flora, the symptoms manifested are nonspecific, and such a diagnosis could be easily missed, resulting in delay of care and disease progression.

About the authors

Caleb Nieves-Velez

Department of Internal Medicine, HCA Healthcare Las Palmas/Del Sol

Author for correspondence.
Email: info@benthamscience.net

Gilberto Rivera-Gonzalez

Department of Internal Medicine, HCA Healthcare Las Palmas/Del So

Email: info@benthamscience.net

Suresh Antony

Deparment of Infectious Diseases, HCA Healthcare Las Palmas/Del Sol

Email: info@benthamscience.net

References

  1. Sharkawy AA. Cervicofacial actinomycosis and mandibular osteomyelitis. Infect Dis Clin North Am 2007; 21(2): 543-56. viii. doi: 10.1016/j.idc.2007.03.007 PMID: 17561082
  2. Ferry T, Valour F, Karsenty J, et al. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infect Drug Resist 2014; 7: 183-97. doi: 10.2147/IDR.S39601 PMID: 25045274
  3. Boyanova L, Kolarov R, Mateva L, Markovska R, Mitov I. Actinomycosis: A frequently forgotten disease. Future Microbiol 2015; 10(4): 613-28. doi: 10.2217/fmb.14.130 PMID: 25865197
  4. Sezer B, Akdeniz BG, Günbay S. Hilmioğlu-Polat S, Başdemir G. Actinomycosis osteomyelitis of the jaws: Report of four cases and a review of the literature. J Dent Sci 2017; 12(3): 301-7. doi: 10.1016/j.jds.2013.02.031 PMID: 30895066
  5. Lo Muzio L, Favia G, Lacaita M, et al. The contribution of histopathological examination to the diagnosis of cervico-facial actinomycosis: a retrospective analysis of 68 cases. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology 2014; 33(11): 1915-8. doi: 10.1007/s10096-014-2165-0
  6. Steininger C, Willinger B. Resistance patterns in clinical isolates of pathogenic Actinomyces species. J Antimicrob Chemother 2016; 71(2): 422-7. doi: 10.1093/jac/dkv347 PMID: 26538502
  7. Wong VK, Turmezei TD, Weston VC. Actinomycosis. BMJ 2011; 343(oct11 3): d6099. doi: 10.1136/bmj.d6099 PMID: 21990282
  8. Smego RA Jr, Foglia G. Actinomycosis. Clin Infect Dis 1998; 26(6): 1255-61. doi: 10.1086/516337 PMID: 9636842
  9. Curi MM, Dib LL, Kowalski LP, Landman G, Mangini C. Opportunistic actinomycosis in osteoradionecrosis of the jaws in patients affected by head and neck cancer: Incidence and clinical significance. Oral Oncol 2000; 36(3): 294-9. doi: 10.1016/S1368-8375(99)00080-9 PMID: 10793333
  10. Tarner IH, Schneidewind A, Linde HJ, et al. Maxillary actinomycosis in an immunocompromised patient with longstanding vasculitis treated with mycophenolate mofetil. J Rheumatol 2004; 31(9): 1869-71. PMID: 15338517
  11. Hansen T, Kunkel M, Springer E, et al. Actinomycosis of the jaws- -histopathological study of 45 patients shows significant involvement in bisphosphonate-associated osteonecrosis and infected osteoradionecrosis. Virchows Archiv an international journal of pathology 2007; 451(6): 1009-17. doi: 10.1007/s00428-007-0516-2
  12. Vázquez E, López-Arcas JM, Navarro I, Pingarrón L, Cebrián JL. Maxillomandibular osteomyelitis in osteopetrosis. Report of a case and review of the literature. Oral Maxillofac Surg 2009; 13(2): 105-8. doi: 10.1007/s10006-009-0151-y PMID: 19219469
  13. Kaplan I, Anavi K, Anavi Y, et al. The clinical spectrum of Actinomyces-associated lesions of the oral mucosa and jawbones: Correlations with histomorphometric analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108(5): 738-46. doi: 10.1016/j.tripleo.2009.06.019 PMID: 19748292
  14. Finley AM, Beeson MS. Actinomycosis osteomylelitis of the mandible. Am J Emerg Med 2010; 28(1): 118.e1-4. doi: 10.1016/j.ajem.2009.04.026 PMID: 20006231
  15. Vigliaroli E, Broglia S, Iacovazzi L, Maggiore C. Double pathological fracture of mandibula caused by actinomycotic osteomyelitis: A case report. Minerva Stomatol 2010; 59(9): 507-17. PMID: 20940689
  16. Garg R, Schalch P, Pepper JP, Nguyen QA. Osteomyelitis of the hard palate secondary to actinomycosis: A case report. Ear Nose Throat J 2011; 90(3): E11-2. doi: 10.1177/014556131109000316 PMID: 21412725
  17. Figueiredo LMG, Trindade SC, Sarmento VA, de Oliveira TFL, Muniz WR, de Hollanda Valente RO. Actinomycotic osteomyelitis of the mandible: An unusual case. Oral Maxillofac Surg 2013; 17(4): 299-302. doi: 10.1007/s10006-012-0381-2 PMID: 23239430
  18. Lau L, Darraj M, Keynan Y. Mandibular Actinomyces osteomyelitis mimicking osteosarcoma. JMM Case Rep 2016; 3(6) doi: 10.1099/jmmcr.0.005073
  19. Ayoade F, Olayiwola A, Li A. "Holes" in the Jaw—a report of two cases of periapical actinomycosis. Diseases 2018; 6(3): 79. doi: 10.3390/diseases6030079 PMID: 30200654
  20. Lee Y, Lim L, Lee K. Actinomycotic osteomyelitis of the mandible: A case report. Journal of Oral Medicine and Pain 2019. https://www.journalomp.org/journal/view.html?doi=10.14476%2Fjomp.2019.44.3.140
  21. Simre S, Jadhav A, Patil C. Actinomycotic osteomyelitis of the mandible - A rare case report. Ann Maxillofac Surg 2020; 10(2): 525-8. doi: 10.4103/ams.ams_99_20 PMID: 33708610
  22. Gupta N, Aggarwal A, Ramteke P, Soneja M. Mandibular osteomyelitis due to Actinomyces spp. BMJ Case Rep 2020; 13(5): e235744. doi: 10.1136/bcr-2020-235744 PMID: 32398252
  23. Singh S, Singh J, Chandra S. Actinomycotic osteomyelitis of mandible: An infrequent case presentation. Journal of Research in Dental Sciences 2020; 11(3): 151-5. doi: 10.4103/srmjrds.srmjrds_47_20
  24. Aghahosseini F, Ghasemzadeh Hoseini E, Mahdavi N. Actinomycotic osteomyelitis of the maxilla in a patient on phenytoin. Front Dent 2022; 19: 3. doi: 10.18502/fid.v19i3.8511 PMID: 35937152
  25. Khan N. Actinomycosis osteomyelitis of the mandible in a 71-year-old patient: A case report. The South African Dental Journal SADA 2022; 77(10): 625-7. doi: 10.17159/2519-0105/2022/v77no10a6

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Statistics

Views

Abstract: 1742

PDF (English): 560

Dimensions

Article Metrics

Metrics Loading ...

PlumX


Copyright (c) 2024 Bentham Science Publishers