Differential diagnosis and treatment of periodontitis-mimicking actinomycosis

Kim, Nam Ryang; Park, Jun‐Beom; Ko, Youngkyung

doi:10.5051/jpis.2012.42.6.256

Cited by 9 publications

(6 citation statements)

References 13 publications

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“…13 In a recent case reports, Rodan and Nam Ryang Kim reported presence of actinomycosis in periodontally affected sites. 14,15 In the present case, the Actinomyces species affected tooth was periodontally and endodontically involved and patient showed poor oral hygiene which The treatment for actinomycosis includes combination of surgical debridement of the involved tissues and the prolonged administration of antibiotics. The traditional treatment is usually a long-term course of penicillin, which includes 1 month of intravenous penicillin G (1 to 6 million units per day for cervicofacial type and 10 to 20 million units per day for thoracic and abdominal type), followed by weeks to months of oral penicillin.…”

Section: Discussionmentioning

confidence: 70%

Management of an Unresponsive Periodontal Lesion in an Endodontic Involved Tooth Complicated by Actinomyces Species

Kini¹,

Ls²,

Padhye³

et al. 2014

Journal of Contemporary Dentistry

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Actinomycosis is an infectious disease caused by Actinomyces species found as a commensal in oral flora. However, it does cause opportunistic infections with localized granulomatous and suppurative lesions intraorally once the integrity of the oral mucosal barrier is compromized and access to the underlying tissues or jaw bones is gained. The present case report highlights an unresponsive periodontal lesion associated with an actinomycotic infection in an endodontically involved tooth. The gingiva in relation to the tooth showed profuse spontaneous bleeding and suppurative discharge after multiple appointments of initial therapy which required histopathologic and microbiological assessment for diagnosis. On establishing the diagnosis of actinomycosis, treatment involved extraction of the tooth. This highlights the importance of microbiological investigations in unresponsive periodontal lesions. How to cite this article Mistry AR, Pereira R, Kini V, Padhye A, Poonja LS, Natrajan S. Management of an Unresponsive Periodontal Lesion in an Endodontic Involved Tooth Complicated by Actinomyces Species. J Contemp Dent 2014;4(3):167-172.

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Section: Discussionmentioning

confidence: 70%

Management of an Unresponsive Periodontal Lesion in an Endodontic Involved Tooth Complicated by Actinomyces Species

Kini¹,

Ls²,

Padhye³

et al. 2014

Journal of Contemporary Dentistry

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“…The typical mass at the angle of the jaw (lumpy jaw), draining sinuses with granules from discharging ulcers, abscess formation, fistulae and fibrous tissue formation are not always present, as typified by our cases. In a similar fashion, Kim et al reported a presentation of actinomycosis mimicking periodontitis without the other classic features associated with cervicofacial actinomycosis [ 7 ].…”

Section: Discussionmentioning

confidence: 97%

“Holes” in the Jaw—A Report of Two Cases of Periapical Actinomycosis

Ayoade

Olayiwola

2018

Diseases

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Periapical actinomycosis is a relatively rare form of cervicofacial actinomycosis, which typically involves the periapical region with subsequent potential spread to the jaw bones. We hereby present two cases of periapical actinomycosis. Both patients presented with jaw pain and “holes” in their gum and lacked the characteristic clinical features commonly seen in cervicofacial actinomycosis such as jaw mass, draining ulcers, sinuses and fistulae. The first patient was an immunocompetent host with chronic stable medical conditions but with a rather bad dentition requiring multiple recent teeth extractions. The second patient was edentulous, had refractory multiple myeloma, was on low-dose chronic steroids and pomalidomide therapy and therefore relatively immunocompromised. Both cases of actinomycosis were diagnosed by jaw bone histopathology, which showed characteristic sulfur granules and embedded Actinomyces-like organisms. The two patients had excellent clinical response to six months of penicillin therapy without any need for surgical intervention. The cases remind clinicians of including actinomycosis in the differential diagnosis of periapical lesions and illustrates the possibility of achieving cure with non-surgical treatment.

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“…The isolation of Actinomyces spp. from blood culture is traditionally regarded as clinically significant [61]. However, the possibility of contaminants does exist [62].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Actinomyces viscosus Bacteremia

Hsiao

Lee

et al. 2021

Medicina

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Background and Objectives: Actinomyces species are part of the normal flora of humans and rarely cause disease. It is an uncommon cause of disease in humans. The clinical features of actinomycosis have been described, and various anatomical sites (such as face, bones and joints, respiratory tract, genitourinary tract, digestive tract, central nervous system, skin, and soft tissue structures) can be affected. It is not easy to identify actinomycosis because it sometimes mimics cancer due to under-recognition. As new diagnostic methods have been applied, Actinomyces can now more easily be identified at the species level. Recent studies have also highlighted differences among Actinomyces species. We report a case of Actinomyces viscosus bacteremia with cutaneous actinomycosis. Materials and Methods: A 66 years old male developed fever for a day with progressive right lower-leg erythematous swelling. Blood culture isolates yielded Actinomyces species, which was identified as Actinomyces viscosus by sequencing of the 16S rRNA gene. In addition, we searched for the term Actinomyces or actinomycosis cross-referenced with bacteremia or “blood culture” or “blood stream” from January 2010 to July 2020. The infectious diseases caused by species of A. viscosus from January 1977 to July 2020 were also reviewed. Results: The patient recovered well after intravenous ampicillin treatment. Poor oral hygiene was confirmed by dental examination. There were no disease relapses during the following period. Most cases of actinomycosis can be treated with penicillin. However, clinical alertness, risk factor evaluation, and identification of Actinomyces species can prevent inappropriate antibiotic or intervention. We also compiled a total of 18 cases of Actinomyces bacteremia after conducting an online database search. Conclusions: In summary, we describe a case of fever and progressive cellulitis. Actinomyces species was isolated from blood culture, which was further identified as Actinomyces viscosus by 16S rRNA sequencing. The cellulitis improved after pathogen-directed antibiotics. Evaluation of risk factors in patients with Actinomyces bacteremia and further identification of the Actinomyces species are recommended for successful treatment.

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Differential diagnosis and treatment of periodontitis-mimicking actinomycosis

Cited by 9 publications

References 13 publications

Management of an Unresponsive Periodontal Lesion in an Endodontic Involved Tooth Complicated by Actinomyces Species

Management of an Unresponsive Periodontal Lesion in an Endodontic Involved Tooth Complicated by Actinomyces Species

“Holes” in the Jaw—A Report of Two Cases of Periapical Actinomycosis

Clinical Characteristics of Actinomyces viscosus Bacteremia

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