An unusual case of periapical actinomycosis

Abstract

Actinomycosis is a granulomatous infection of the cervicofacial, thoracic, abdominal and cerebral regions. Periapical actinomycosis is a rare form of cervicofacial actinomycosis, which is a persistent lesion that usually does not respond to routine endodontic treatment. The prevalence of this infection is indeed low and therefore is not a common cause of endodontic failure. We report a case of periapical actinomycosis in a 24 yr old patient who presented with a complaint of swelling and pain in the maxillary incisors. The accidental finding of sulphur granules during the endodontic surgery led to the provisional diagnosis of periapical actinomycosis. Upon biopsy, actinomycosis was diagnosed where classic colonies were demonstrated. Apicoectomy was performed and the patient was maintained on follow up. Satisfactory healing was achieved after 10 months. Early diagnosis of such lesions with actinomyces is important since it directly impacts the treatment plan.