Actinomycotic osteomyelitis of the mandible: an unusual case

Lim

et al. 2019

JOMP

Actinomycosis is rare, chronic, slowly progressive disease caused by gram-positive anaerobic organisms from the Actinomycosis family that normally colonizes the oral cavity. Actinomycotic osteomyelitis is even more rare and refractory disease because diagnosis by bacterial culture is not easy. In our case, 80-year-old man visited our clinic with a complaint of swelling and severe sinus tracts without teeth evolvement on anterior mandible. Computed tomography (CT) scan demonstrated erosive bone destruction on anterior mandible, clinically suspected actinomycotic osteomyelitis. The patient also had thoracic actinomycosis on Lt. lower lung. We could diagnosis actinomycosis by histopathologic examination. He treated by conservative surgery and long term antibiotics. After 2 year, no recurrence was seen in CT scan.

Section: Introductionmentioning

confidence: 71%

Actinomycotic Osteomyelitis of the Mandible: A Case Report

Lim

et al. 2019

JOMP

J Korean Assoc Oral Maxillofac Surg

“…CFA is the most common form of actinomycotic infection10. In addition to CFA, actinomycotic infection is a potential complication in bisphosphonate-related osteonecrosis of the jaw and osteoradionecrosis11.…”

Section: Discussionmentioning

confidence: 99%

The treatment of actinomycosis mimicking a retained root tip: a confusing case

Cho

2016

Actinomycosis is an infection caused by the actinomyces genus and is associated with trauma or previous infection. A 58-year-old male patient was referred from a private dental clinic for root extraction of the lower right molar. The x-ray showed fractured root-like material distal to the distal root of the lower right second molar. A biopsy during extraction of the root-like material was performed, which revealed a sequestrum with actinomycosis by a pathological examination. In this case, the radiopacity of the suspicious lesion was higher than that of the surrounding alveolar bone, which confused it with the root tip. The diagnosis of actinomycosis required long-term antimicrobial therapy, which is very different from simple extraction or removal of sequestrum.

“…With the application of antibiotics, the implementation of incision and drainage of abscesses, and with the removal of infected teeth, most infections can usually be treated fast and successfully [ 1 , 2 , 3 , 4 , 5 ]. Nevertheless, sometimes persistent subacute and chronic infections occur, where adequate therapy can be a great challenge for practitioners and where treatment can take a long time [ 6 ]. Especially, delayed-onset wound infections after third molar extraction, which occur several weeks after suture removal and after discharge [ 7 ], can cause varying symptoms affecting hard and soft tissues [ 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Figueiredo et al reported that those infections are normally caused by anaerobic bacteria of the oral flora, e.g., Fusobacterium, Peptostreptococcus , Porphyromonas, and Prevotella strains, which in most cases can be successfully treated with combinations of surgical revision and antibiotics [ 9 ]. Other authors have shown that specific infections like Actinomycosis, which need specific therapy, have to be considered [ 6 , 12 , 13 ]. Additionally, cases of osteomyelitis of the jaw after third molar surgery have been previously described [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

A New Type of Chronic Wound Infection after Wisdom Tooth Extraction: A Diagnostic Approach with 16S-rRNA Gene Analysis, Next-Generation Sequencing, and Bioinformatics

et al. 2020

Delayed-onset infections are rare postoperative complications of lower third molar extractions. This article presents a case of a chronic combined hard and soft tissue infection after the extraction of a third molar, where the causative organisms could only be elucidated by molecular methods. Experimental 16S-rRNA gene analysis with next-generation sequencing and bioinformatics was used to identify the bacterial spectrum of the infection. 16S-rRNA gene analysis delivered the microbiome of the abscessing inflammation while standard culture and laboratory examinations were all sterile. The microbiome showed a mixed bacterial infection with a dominance of Delftia and Alcanivorax (spp.) besides other bacteria of the normal oral flora. Using 16S-rRNA-gene analysis, next-generation sequencing, and bioinformatics, a new type of chronic wound infection after wisdom tooth extraction was found. The property of Delftia and Alcanivorax (spp.) as water-affine environmental bacteria raises suspicion of infection from contaminated water from a dental unit. Thus, osteotomies of teeth should only be done with sterile cooling water. The 16S-rRNA gene analysis should become a part of the routine diagnostics in medical microbiology.