Cases reported • Actinomycosis, Cervicofacial

1/5. Case report of regional alveolar bone actinomycosis: a juvenile periodontitis-like lesion.

BACKGROUND: Cervicofacial actinomycosis infection most often involves the mandibular bone and rarely the alveolar crest. methods: We describe a 14-year-old patient who had actinomycosis involving the alveolar bone at the left lower dental quadrant region. Resembling juvenile periodontitis, it was difficult to diagnose properly and resulted in devastating dental and periodontal consequences: loss of one tooth with most of its adjacent regional alveolar bone, severely compromising the support of two other teeth. RESULTS: With the diagnosis came successful treatment, including surgical removal of the soft and hard tissues with concomitant prolonged penicillin administration. CONCLUSIONS: We feel that this case should raise the interest and concern of both the periodontist and the general practitioner so that early diagnosis can be obtained, significantly improving the clinical outcome.

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2/5. Unusual presentation of mandibular extraoral sinus in a fourteen year old girl: a case report.

A case of fourteen year old healthy girl with complaint of a discharging sinus on the lower right side of face is reported. All teeth were vital and there was no evidence of periodontitis. There was no history of extraction of a tooth. Total leucocyte count, differential leucocyte count, fasting blood sugar, chest x-ray and routine urine examination were within normal limits. actinomycosis and scrofuloderma which simulate such a condition were ruled out by culture study. The intraoral periapical x-ray of mandibular molar showed questionable periapical changes at the time of presentation. But definite osteolysis was observed in the repeat radiograph after three months. It was decided to extract the second molar and curette the sinus tract. The extraction proved to be difficult. On examination of the extracted tooth, it was found that the mandibular second molar and second premolar were fused together. The radiograph of the tooth taken after extraction showed confluence of the premolar pulp with the periodontal membrane. On follow up, the lesion was found to heal satisfactorily.

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3/5. Rare lesions of the oral cavity: case report of an actinomycotic lesion limited to the gingiva.

actinomycosis is an infectious disease that frequently has chronic granulomatous and suppurative lesions caused by saprophytic actinomyces species. Although cervicofacial actinomycosis is known to be the most common type, intraorally and periodontally types occur rarely in a localized fashion. The present case reports on an adult periodontitis patient with a diffuse and atypic actinomycotic lesion which was limited to the gingiva and had an abscess formation, a large desquamation and subsequent exposure of the alveolar bone in the involved region. Diagnosis was based on histopathological examination, the history of the case and clinical nature of the lesion. The patient responded to daily administration of 100 g doxcycycline (first day-bid) for 3 weeks and 0.2% chlorhexidine gluconate irrigation (following tooth brushing) performed with oral hygiene reinforcement and periodontal debridement procedures. Complete improvement of the lesion was observed after 5 weeks. Due to the opportunistic characteristics of the actinomycotic infection, early and adequate differential diagnosis of actinomycosis prior to therapeutic attempts, as well as management steps, are of great importance in the oral cavity to prevent the spread of the disease.

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4/5. Nonhealing extraction site due to actinomyces naeslundii in patient with AIDS.

There are many oral complications of human immunodeficiency virus infection. One of the infectious sequelae is contamination and delayed healing of the tooth extraction site. We report a case of a nonhealing extraction site in a patient with the acquired immunodeficiency syndrome. Histologic and microbiologic evaluation determined the causative species of bacterium to be actinomyces naeslundii. Diagnosis and treatment are discussed.

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5/5. Cervicofacial actinomycosis in man.

Two cases of advanced jaw destruction due to actinomyces is reported; one with diabetic diathesis and a history of tooth extraction the other had a trauma of the mandible with the fracture; good results were obtained with penicillin therapy.

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