Mandibular Actinomyces osteomyelitis complicating florid cemento-osseous dysplasia: case report

Abstract

BackgroundApart from neoplastic processes, chronic disfiguring and destructive diseases of the mandible are uncommon.Case PresentationWe report, perhaps for the first time, the simultaneous occurrence of two such conditions in one patient, in a case that emphasizes the importance of bone biopsy in establishing the correct diagnosis. Florid cemento-osseous dysplasia (FCOD) is a chronic, disfiguring condition of the maxillofacial region. This relatively benign disease is primarily observed in middle-aged women of African ancestry. Cervicofacial actinomycosis is an uncommon and progressive infection caused by bacilli of the Actinomyces genus that typically involves intraoral soft tissues but may also involve bone. The accurate diagnosis of actinomycosis is critical for successful treatment. A diagnosis of osteomyelitis caused by Actinomyces bacteria was diagnosed by bone biopsy in a 53 year-old African-American woman with a longstanding history of FCOD after she presented with a new draining ulcer overlying the mandible.ConclusionsClinicians should be aware of the possibility of actinomycosis arising in the setting of FCOD, and the importance of bone biopsy and cultures in arriving at a definitive and timely diagnosis.

Suppuration‐Associated Bacteria in Patients With Chronic and Aggressive Periodontitis

“…Other groups of microorganisms associated in a high number of SUP sites included species of streptococci and Actinomyces spp. Although these host‐compatible species are predominant colonizers of a periodontally healthy subgingival microbiota, they have also been commonly found in periodontal abscesses 21‐23 …”

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“…Lesions are often asymptomatic and indolent in nature and may present as incidental findings on radiographs [20]. Radiographically, the lesions present a mixed radiolucent and radiopaque "cotton wool" appearance [21].…”

Osteomyelitis as a possible cause of rootless Turner’s tooth: a case report

“…In addition, special infections such as tuberculosis, syphilis, actinomycosis can associate with osteomyelitis [4] .…”