Actinomycotic Osteomyelitis Research Articles

Actinomycotic osteomyelitis of maxillary sinus and hard palate in a post-COVID-19 patient.

Actinomycotic osteomyelitis of maxillary sinus and hard palate in a post-COVID-19 patient.

The "Lumpy Jaw" Disease-Treatment and Diagnostical Challenge of Actinomycotic Osteomyelitis.

Osteomyelitis is a serious entity that can occur in many different locations. Especially in the mandible, osteomyelitis can show different clinical courses, which differ clearly from other anatomical regions in terms of severity and treatment. Osteomyelitis in the mandible is often caused by mixed species of the oral cavity. A species causing subacute/chronic osteomyelitis can be actinomyces. Actinomycotic osteomyelitis of the jaw represents a diagnostic and treatment challenging disease. This article describes our perspective on the therapy pillars treating actinomycotic osteomyelitis. The rapid introduction of the two therapeutic elements (antibiosis/surgical therapy) is crucial regarding the outcome of this entity.

Actinomycotic Osteomyelitis and Myiasis in Oroantral Communication: Clinicopathological and Tomographic Findings

Actinomycotic osteomyelitis of the maxilla presenting with oroantral communication is very rare, herein we report the first case of this condition in association with myiasis. A 50-year-old man reported chronic sinusopathy and a non-healing maxillary lesion, with 30 years of evolution, presenting occasional nasal and intraoral purulent discharge, with foul smell, and recurrent episodes of larvae presence. Cone beam computed tomography showed a large hyperdense image inside the left maxillary sinus, with focal areas with soft tissue density, and extensive discontinuity of the maxillary sinus floor, confirming the oroantral fistula. The necrotic tissue curetted during surgery presented hard consistency, and dark greenish color, and was submitted for histopathological analysis. Microscopically, necrotic bone, masses of filamentous bacteria colonie s, compatible with actinomycosis, and large rhomboidal structures surrounded by eosinophilic capsule - suggestive of larvae, were observed. The diagnosis of actinomycotic osteomyelitis with presence of structures compatible with larvae was established.

Actinomycotic osteomyelitis of the maxilla in a female patient: A rare case report with the review of the literature.

Actinomycotic osteomyelitis is a rare chronic suppurative, granulomatous, fibrosing saprophytic infection. It is an endogenous infection caused by the Actinomyces species, which are part of the normal oral microflora. There is a male predilection for this type of infection, with the male to female ratio of 4:1. Though the etiopathogenesis of the infection is unclear, it is mostly attributed to the disruption of the normal oral microflora and the invasion of the microorganism into deeper tissues through a break in the mucosal barrier due to damage from trauma, extraction or previous injury. The portal of entry can be through the pulpal, periodontal or mucosal route, causing the purulent and necrotic infection of soft tissue, bone, or both. The diagnosis is usually considered when there is a persistent infection without the presence of regional lymphadenopathy and is usually confirmed through the histopathological depiction of the bacterial colonies - 'ray fungus' - as obtaining the positive culture of the causative microorganisms is difficult and is reported to be effective in less than 50%. Patients with such infections are managed with surgical debridement, followed by antibiotic therapy for a longer time period. Recent advances have been emphasized for an early diagnosis and a better prognosis of the therapy. Therefore, this paper aimed to present a rare case of actinomycotic osteomyelitis of the maxilla in a 45-year-old female patient, and also to review the literature on this rare infection.

Prediction models for early diagnosis of actinomycotic osteomyelitis of the jaw using machine learning techniques: a preliminary study.

BackgroundThis study aimed to develop and validate five machine learning models designed to predict actinomycotic osteomyelitis of the jaw. Furthermore, this study determined the relative importance of the predictive variables for actinomycotic osteomyelitis of the jaw, which are crucial for clinical decision-making.MethodsA total of 222 patients with osteomyelitis of the jaw were analyzed, and Actinomyces were identified in 70 cases (31.5%). Logistic regression, random forest, support vector machine, artificial neural network, and extreme gradient boosting machine learning methods were used to train the models. The models were subsequently validated using testing datasets. These models were compared with each other and also with single predictors, such as age, using area under the receiver operating characteristic (ROC) curve (AUC).ResultsThe AUC of the machine learning models ranged from 0.81 to 0.88. The performance of the machine learning models, such as random forest, support vector machine and extreme gradient boosting was significantly superior to that of single predictors. Presumed causes, antiresorptive agents, age, malignancy, hypertension, and rheumatoid arthritis were the six features that were identified as relevant predictors.ConclusionsThis prediction model would improve the overall patient care by enhancing prognosis counseling and informing treatment decisions for high-risk groups of actinomycotic osteomyelitis of the jaw.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12903-022-02201-6.

Actinomycotic osteomyelitis of mandible - A case report

Actinomycosis is an infection caused by filamentous, gram positive anaerobic bacteria. Actinomycosis of jaw bone is rare and its diagnosis is often difficult. Incidence of Actinomyces infectionin mandible is 53.6%. This case report presents an actinomycotic osteomyelitis of mandible in a 55- year-old male patient presented withpain and multiple extra-oral sinuses (in right submandibular region) which was treated successfully with surgery and medication.

Actinomycotic Osteomyelitis of Maxilla in a Diabetic Patient- “A Rare Case Report & Review of Literature”

Actinomycosis may be a relatively rare infection caused by saprophytic bacteria of the mouth and alimentary canal which will become pathogenic. The chronic hyperglycemia in Diabetes Mellitus induces events that promote structural changes in various tissues and are related to problems in wound healing. This infection remains largely unknown to most clinicians due to its different presentations, and palatal involvement is extremely rare. This report describes the case of a 50-year-old man who was diagnosed with actinomycosis involving mucosal surface. The main clinical, histopathologic, and therapeutic characteristics and diagnosis of actinomycosis are reviewed. Till date, 4 cases of actinomycosis involving the palatal surface are reported.

English

Involvement of the submandibular gland in actinomycotic osteomyelitis in the absence of sinus is rare. Cervicofacial form is characterized by contiguous spread, suppurative osteomyelitic & granulomatous inflammation of the mandible and formation of multiple abscesses and hallmark discharging sinuses draining serosanguinous fluid containing sulphur granules. As the imaging finding of this entity is rarely described, in this case report, a rare case of mandibular actinomycotic osteomyelitis, with a submandibular swelling, but without draining sinus is reported. The imaging findings of cone beam computed tomography (CBCT) & ultrasonography (US) of the case are discussed with a review. In subacute stage, mandibular actinomycosis may show no hallmark sinuses. Sclerotic margins around the lesion may be found on radiograph. Imaging is useful in ruling out clinical diagnostic challenge when it includes involvement of mandible & submandibular region. Cervicofacial actinomycosis commonly occurs as perimandibular infection, rarely as osteomyelitis of the mandible.1 It may present as two distinct morphological patterns; first, "lumpy jaw," and second, simulating an acute pyogenic infection affecting the submandibular area, discharging sinus being a hallmark finding.1 Other variant reported include chronic osteitis, osteolytic lesion, hard nodule on the tongue, lockjaw, periapical, or paradental abscess. Diagnosis of cases presenting in multiple areas in the absence of multiple discharging sinuses is a challenge.2 Usefulness the imaging findings are rarely enumerated. This report is of a twin presentation of a non - sinus forming actinomycotic mandibular osteomyelitis and a submandibular swelling, along with a review of various diagnostic imaging features.

An Actinomyces Long-Bone Osteomyelitis Case Report and Review

Abstract Historically, anaerobic bacteria as monomicrobial pathogens or components of polymicrobial infections have been found to play a minor role in osteomyelitis. Various Actinomyces species reside as constituents of the normal human microbial flora found in the oropharynx and in the most people may also be present as commensal microorganisms in the gastrointestinal, genitourinary, and, to a lesser degree, the upper respiratory tracts. Bone infections due to Actinomyces species are relatively uncommon and usually associated with concomitant cervicofacial disease. To date, only a sparse amount of cases of long bone osteomyelitis due to Actinomyces bacteria have been published in the medical literature. We report a case of monomicrobial subacute late-onset tibia bone osteomyelitis involving Actinomyces presenting 10 years after an open reduction and internal fixation surgical procedure performed to stabilize a traumatic fracture and review actinomycotic osteomyelitis including the rare association of Actinomyces odontolyticus with long bone infections.

Actinomycotic osteomyelitis of the mandible with bone destruction: Two case reports with a review of the Japanese literatures

AbstractMandibular actinomycosis, which is mainly caused by Actinomyces israelii, is characterized by trismus and multiple abscesses. The associated destruction of the jaw bone in cases of mandibular actinomycosis is rare. As the clinical symptoms and imaging findings of this disease are similar to those in malignant tumors, a biopsy should be performed at an early stage to facilitate a definitive diagnosis. To date, no studies have reported on the incidence and management of actinomycotic osteomyelitis. Here, we report two cases of actinomycotic osteomyelitis with bone destruction, and review the literature for similar cases that have been reported in Japan.

A rare case of actinomycotic osteomyelitis of calcaneum: Presented with subtalar arthritis

We are reporting an unusual case of actinomycosis infection which presented with subtalar arthritis. Actinomycosis is a chronic granulomatous disease caused by Gram-positive anaerobic bacteria. Actinomycosis is very rare and of the cases reported Cervicofacial infection is the most frequent clinical presentation. Hematogenous osteomyelitis at distant sites can occur in the rare instance in immunocompromised or pediatric patients, only a few cases have been reported in healthy patients. Case Report: A 39years, female patient presented with pain, swelling around the right ankle for 4 years with healed sinuses over the lateral aspect. She was treated for the discharging sinuses of right ankle and foot 5 years back with antibiotics and surgery elsewhere. She had a history of taking treatment (ATT for 6months) for pulmonary TB, 10years back. X-rays and Magnetic resonance imaging showed a distorted subtalar joint with multifocal intraosseous lesions in the calcaneum. Curettage and subtalar arthrodesis with Cannulated cancellous screws was done and supported with short-term immobilization. The tissue culture, fungus culture, acid-fast bacillus (AFB) culture, AFB smear, and tuberculosis polymerase chain reaction test results of intraop samples were negative. A pathologic examination confirmed the presence of actinomycosis. The patient was treated with intravenous penicillin for 2 weeks followed by Oral Doxycycline for 6 weeks, given no evidence of active infection intraoperatively. After 1year follow-up, the patient had no signs of recurring infection or complications and she is ambulant pain-free.Conclusion: Actinomycosis of the foot, though rare, can mimic tuberculosis in areas with a high prevalence of tuberculosis. In patients with recurrent discharging sinuses, a high index of suspicion is warranted to early diagnose it.

Actinomycotic osteomyelitis of mandible: An infrequent case presentation

Actinomycosis is a rare entity causing acute or chronic infections by filamentous bacteria, Actinomyces species. It usually affects soft tissue but rarely affects bone leading to Actinomycotic osteomyelitis. We report a case of 22-year-old male clinically and radiologically diagnosed as Osteomyelitis, and histopathologically confirmed as Actinomycotic osteomyelitis. The current study also highlights the importance of histopathological examination of any clinically suspected lesion, due to low biological identification rate. Correct diagnosis of the disease avails adequate treatment and thus better prognosis.

Actinomycotic osteomyelitis of a long bone in an immunocompetent adult: a case report and literature review

BackgroundActinomycosis is a rare, chronic granulomatous disease caused by Gram-positive anaerobic bacteria that colonize the oral cavity. Cervicofacial actinomycosis is the most frequent clinical presentation of actinomycosis, but hematogenous osteomyelitis at distant sites can occur in rare instance in immunocompromised or pediatric patients, only a few cases have been reported in healthy patients. Here we described a new case of distal femur osteomyelitis caused by Actinomyces in an adult patient who was immunocompetent and had no predisposing factors.Case presentationA woman aged 52 years with no history of trauma presented with severe pain, swelling, and increased local heat in the proximal area of the right knee 3 weeks after she first noticed discomfort. Magnetic resonance imaging showed persistent osteomyelitis of the distal metaphysis and diaphysis of the femur with a multifocal intraosseous abscess pocket. An incision and drainage of the abscess were conducted. The tissue culture, fungus culture, acid fast bacillus (AFB) culture, AFB smear, and tuberculosis polymerase chain reaction test results were negative. A pathologic examination confirmed the presence of actinomycosis. The patient was successfully treated with intravenous penicillin G for 8 weeks followed by oral amoxicillin-clavulanate for 6 weeks with repeated surgical debridement and drainage. After a 5-year follow up, the patient had no signs of recurring infection or complications and she had full range of movement in the affected knee.ConclusionsAlthough rare, actinomycotic osteomyelitis can occur in healthy people. Furthermore, actinomycotic osteomyelitis is easily misdiagnosed as tuberculosis in areas with a high prevalence of tuberculosis. To detect and identify the bacteria accurately, pathologic examination should be performed as well as culture tests, because the probability for culture confirmation of actinomycosis is quite low. The initial treatment is vital to a successful outcome without ostectomy or amputation.

A case of actinomycotic osteomyelitis of the mandibular ramus in a child

A case of actinomycotic osteomyelitis of the mandibular ramus in a child

Actinomycotic Osteomyelitis of the Mandible: A Rare Case Report

Introduction: Actinomycosis is a rare soft tissue infection which seldom involves the bone. Actinomycotic Osteomyelitis, particularly affecting the cervicofacial region, is scarcely reported in the adult population.

Chronic actinomycotic osteomyelitis of the mandible: A case report

Chronic actinomycotic osteomyelitis of the mandible: A case report

Actinomycotic Osteomyelitis of the Maxilla - A Delusive Presentation.

A 79-year-old female patient reported to the Department of Oral Medicine and Radiology, with a complaint of a progressively enlarging painless ulcer of the palate of six months duration. The ulcer caused difficulty in speech and swallowing due to nasal regurgitation. Her medical history revealed that she was a chronic diabetic patient with poor glycemic control. She was on insulin one year back and now on oral hypoglycemics. She gave a history of carcinoma breast and extensive esophageal candidiasis one year back for which she had undergone treatment. She also complained of severe headache, tiredness, nasal discharge and numbness over the right side of her face and appeared cachectic. Examination of the patient’s face revealed no gross asymmetry. Intraorally, the ulcer measured approximately about 6x6cm involving most of the anterior part of hard palate with irregular and undermined edges [Table/Fig-1]. There was exposed necrotic grey colored bone on the base of the ulcer and discrete areas of black eschar. Slough was seen more towards the periphery of the lesion. Oro-nasal communication of size approximately 1.5x1.5cm was present on the anterior part of the lesion towards right side and a smaller one towards left side. On palpation the lesion was tender. Upper deep cervical lymph nodes were palpable bilaterally. Multiple missing teeth, root stumps and caries exposed teeth were present in the maxillary and mandibular arches. Results of complete blood count and serum electrolyte analysis were within normal limits.

Actinomycotic Osteomyelitis of Maxilla Presenting as Oroantral Fistula: A Rare Case Report.

Actinomycosis is a chronic granulomatous infection caused by Actinomyces species which may involve only soft tissue or bone or the two together. Actinomycotic osteomyelitis of maxilla is relatively rare when compared to mandible. These are normal commensals and become pathogens when they gain entry into tissue layers and bone where they establish and maintain an anaerobic environment with extensive sclerosis and fibrosis. This infection spreads contiguously, frequently ignoring tissue planes and surrounding tissues or organ. The portal of entry may be pulpal, periodontal infection, and so forth which may lead to involvement of adjacent structures as pharynx, larynx, tonsils, and paranasal sinuses and has the propensity to damage extensively. Diagnosis is often delayed and is usually based on histopathology as they are cultured in fewer cases. The chronic clinical course without regional lymphadenopathy may be essential in diagnosis. The management of actinomycotic osteomyelitis is surgical debridement of necrotic tissue combined with antibiotics for 3–6 months. The primary actinomycosis arising within the maxilla with contiguous involvement of paranasal sinus with formation of oroantral fistula is rare. Hence, we present a 50-year-old female patient with chronic sclerosing osteomyelitis of maxilla which presented as oroantral fistula with suppurative and sclerotic features.

放線菌感染を伴ったビスフォスフォネート関連上顎骨骨髄炎の1例

Actinomycosis of the jaw is relatively rare, and few cases arise in the maxilla. In addition, there are few reports of actinomycosis of the jaw in patients who receive bisphosphonates. We report a rare case of bisphosphonate-related osteomyelitis of the maxilla involving Actinomyces infection. The patient was a 71-year-old woman who presented with a diffuse swelling and purulent fistulas in the left maxillary premolar region. Radiographic examination revealed bone destruction with a soft tissue swelling in the maxilla. The suspected clinical diagnosis of this lesion was osteomyelitis or a malignant tumor. A biopsy revealed granulated tissue with colonies of pathogenic microorganisms, and actinomycotic osteomyelitis was diagnosed. Surgical curettage was thus performed, with prolonged administration of penicillin. There has been no recurrence of disease during 6 months of follow-up.

A Case of Actinomycotic Osteomyelitis of the Mandible Treated by Segmental Resection Including the Condylar Process

A Case of Actinomycotic Osteomyelitis of the Mandible Treated by Segmental Resection Including the Condylar Process