Cervicofacial actinomycosis: Diagnosis and management

Oostman, Olga; Smego, Raymond A.

doi:10.1007/s11908-005-0030-0

Cited by 115 publications

(152 citation statements)

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“…In the head and neck region, the most common form of actinomycosis is the cervicofacial form, which is often difficult to distinguish from other inflammatory lesions in this region (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Actinomycosis is not Frequent in the Periapex But is a Persistent Lesion

Esteves

Henriques

Silva³

et al. 2017

Braz. Dent. J.

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Periapical actinomycosis caused by a gram-positive anaerobic pathogen characterizes a typical extra-radicular infection. This study determined the frequency and correlated the content of bacteria colonies with the of periapical actinomycosis size. The study comprised a total of 218 periapical lesions (PL) (cysts, granulomas or abscess). The specimens embedded in paraffin were sliced into 4-µm sections and stained with hematoxylin-eosin, Gram, Periodic Acid-Schiff (PAS) and Grocott's stain. The presence of bacterial colonies composed of filamentous structures labeled with the histochemical stains were described as Actinomyces, and for each case, the bacterial colonies were counted and measured. The correlation between the number and size of bacterial colonies and the size of PL was tested using Pearson's adjusted correlation coefficient. From 218 PL, bacterial colonies were identified in 64 biopsies. Seven cases (0.3%) fulfill the criteria for diagnosis of periapical actinomycosis. All of cases were therapy-resistant and did not showed periapical repair after 12 months of follow-up. Periapical surgery or dental extraction was performed. The correlation test indicated no correlation between the number of bacterial colonies and the lesion size (p=0.752, r=-0.148). However, a larger bacterial colony size generally resulted in a larger periapical lesion (P=0.000, r=0.657). The frequency of periapical actinomycosis was low, and this lesion should be included in the differential diagnosis of PL. The size of the Actinomyces colonies seemed to contribute to increase the size of the periapical lesion.

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Section: Introductionmentioning

confidence: 99%

Actinomycosis is not Frequent in the Periapex But is a Persistent Lesion

Esteves

Henriques

Silva³

et al. 2017

Braz. Dent. J.

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“…3 In the maxillofacial region, infection is frequently of odontogenic origin, the result of oromaxillofacial trauma, dental manipulation, or dental caries. [1][2][3][4][5][6][7][8][9][10] Intraoral and panoramic radiographs are often used to assess various diseases and conditions of the maxilla and mandible in the dental clinic, 3 but the imaging findings are often nonspecific, and differentiating actinomycosis from other inflammatory or infectious conditions or from neoplastic processes is difficult and often necessitates additional imaging.…”

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“…4 Approximately half of patients present with a low-grade fever. 7 Because actinomycosis species are anaerobic bacteria that cannot penetrate healthy tissue, mucosal breakdown is a prerequisite for infection. 5 Roughly half of patients have a history of local trauma resulting in mucosal breakdown, with poor dental hygiene, caries, oral trauma, dental extraction, and an immunocompromised status being important predisposing factors.…”

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“…5 A presumptive diagnosis of actinomycosis can be made by identification of sulfur granules in an abscess or in the secretions from a sinus tract, 6 but only 10% of actinomycotic infections are correctly diagnosed at the time of initial presentation. 7 The diagnosis of actinomycosis is made most accurately by isolation of Actinomyces species in cultures of clinical specimens. 6 The visualization of actinomycotic granules in exudates or in histopathologic tissue sections is strongly supportive of the diagnosis.…”

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“…6 The visualization of actinomycotic granules in exudates or in histopathologic tissue sections is strongly supportive of the diagnosis. 7 In the literature, an enhancing soft tissue mass with invasion in the cervicofacial region and rarefying osteomyelitis in MA have been described. 2 In our study, all lesions had ill-defined, infiltrative margins with surrounding soft tissue inflammatory response that extended to the skin.…”

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Actinomycosis in the Mandible: CT and MR Findings

Sasaki¹,

Kaneda²,

Uyeda

et al. 2013

American Journal of Neuroradiology

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SUMMARY:Mandibular actinomycosis is an uncommon disease. We retrospectively reviewed 6 patients with pathologically proven mandibular actinomycosis who underwent both CT and MR imaging to evaluate the characteristic imaging findings. CT results showed an irregularly marginated lesion with increased bone marrow attenuation, osteolysis, and involvement of the skin in all patients. Periosteal reaction and intralesional gas were seen in 4 patients. MR imaging results revealed low signal on T1-weighted and high signal on T2-weighted images of the mandible, and moderate heterogeneous enhancement was seen in all patients who received intravenous contrast. Cervical lymphadenopathy was not observed. Involvement of the masseter, lateral pterygoid, and medial pterygoid muscles was seen in 4 patients, whereas parotid gland and submandibular gland as well as parapharyngeal space involvement were seen in 3 patients. Familiarity with the imaging findings of mandibular actinomycosis may help to diagnosis this entity. ABBREVIATION: MA ϭ mandibular actinomycosis

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Oral Infection Involving Nocardia and Actinomyces: A Case Report

Arora

Gruwell

Cobb

2018

Clin Adv Periodontics

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Introduction: Both Actinomyces and Nocardia are Gram-positive microbes characterized by a filamentous morphology. Both can be causative agents in slowly progressive, localized, or disseminated infections that are rare and typically occur in immunocompromised patients. Oral infections involving both microorganisms are very rare. Case Presentation:A black male with a history of Type 2 diabetes was referred with a chief complaint of a persistent 3 mm × 3 mm swelling facial to the mandibular central incisors. The swelling was asymptomatic except for occasional discharge of purulent exudate. Examination revealed 5-to 6-mm mesio-lingual and mid-lingual probing depths. Radiographs revealed a well-defined radiolucency between the roots of teeth #24 and #25. A full-thickness gingival flap was reflected exposing an oval-shaped bony defect, which was debrided and the contents submitted for microscopic examination. The resulting defect was filled with demineralized freeze-dried bone allograft (DFDBA) and capped with calcium sulfate. The patient was prescribed amoxicillin and 0.12% chlorhexidine gluconate mouthrinse. Examination of the biopsied tissue revealed both Actinomyces and Nocardia microorganisms. The patient was followed for 24 months and remains symptom-free with noted radiographic evidence of bone fill in the lesion area. Conclusions:This may be the first published report of an oral infection featuring both Actinomyces and Nocardia.The case reinforces the importance of microscopic examination of biopsy material removed from unusual and persistent pathologic lesions that are destructive of bone. Clin Adv Periodontics 2018;8:167-172.

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Cervicofacial actinomycosis: Diagnosis and management

Cited by 115 publications

References 15 publications

Actinomycosis is not Frequent in the Periapex But is a Persistent Lesion

Actinomycosis is not Frequent in the Periapex But is a Persistent Lesion

Actinomycosis in the Mandible: CT and MR Findings

Oral Infection Involving Nocardia and Actinomyces: A Case Report

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