An atypical form of cervicofacial actinomycosis treated with short but intensive antibiotic regimen.

Abstract

Human actinomycosis is a rare soft tissue infection caused by Gram-positive, anaerobic bacteria Actinomyces israelii, a commensal of the oral cavity. The major clinical forms of actinomycosis are cervicofacial, thoracic, abdominal and pelvic forms. The cervicofacial region is most commonly affected. Actinomycosis is sometimes difficult to diagnose and it should be borne in mind in the differential diagnosis of numerous infectious and non-infectious diseases. We report a patient who came with tooth pain and extra-oral swelling which later on presented as multiple draining sinuses. Our initial suspicion was dento-alveolar abscess or osteomyelitis. However, a culture of the discharge and subsequent biopsy revealed actinomycetes, confirming cervicofacial actinomycosis, but presenting itself not as the typical 'lumpy jaw'. The patient was successfully treated conservatively with a short but intensive antibiotic course.

• Authors: Kaushal Mahendra Shah, Amol Karagir, Sampada Kanitkar, Rajesh Koppikar
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2013 (Apr 10 2013) ISSN: 1757-790X [Electronic] England
• PMID: 23580677 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Amoxicillin-Potassium Clavulanate Combination
• Penicillin G

Topics

• Actinomycosis, Cervicofacial (diagnosis, drug therapy, surgery)
• Amoxicillin-Potassium Clavulanate Combination (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Combined Modality Therapy
• Diagnosis, Differential
• Humans
• Male
• Middle Aged
• Penicillin G (therapeutic use)
• Radiography, Panoramic