Simre Saurabh Sunil, Jadhav Anendd A, Patil Chirag S
Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India.
Ann Maxillofac Surg. 2020 Jul-Dec;10(2):525-528. doi: 10.4103/ams.ams_99_20. Epub 2020 Jun 23.
Actinomycetes are a relatively sporadic cause of infection of the head-and-neck region and their appearance is usually uncharacteristic, and hence pose a challenge for the diagnosis. The present article intends to exhibit this rarity afflicting mandible and highlight its management. The present report describes a case of a 55-year-old countryside female who presented with pain and swelling affecting the left side of the mandible. Orthopantomograph and cone-beam computed tomography imaging showed multiple ill-defined radiolucencies and perforations of the buccal and lingual cortical plates. Fine-needle aspiration microbiology was used to ascertain the microbial organism and the patient was treated with amoxicillin + clavulanic acid with curettage of the infected site. The patient responded well to prompt systemic antibiotics and local surgical measures with complete resolution of the infection and spontaneous bone regeneration. Although rare actinomycosis of the mandible is curable and should be included in the differential diagnosis of osteomyelitis of the jaw. Early and accurate diagnosis and prompt intervention confirm better outcomes.
放线菌是头颈部感染相对少见的病因，其表现通常不典型，因此给诊断带来挑战。本文旨在展示这种累及下颌骨的罕见病例，并强调其治疗方法。本报告描述了一例55岁农村女性患者，其出现左侧下颌骨疼痛和肿胀。全景曲面断层片和锥形束计算机断层扫描成像显示多处边界不清的透射区以及颊侧和舌侧皮质骨板穿孔。采用细针穿刺微生物学检查以确定微生物种类，患者接受阿莫西林+克拉维酸治疗，并对感染部位进行刮除术。患者对及时的全身抗生素治疗和局部手术措施反应良好，感染完全消退，骨组织自发再生。尽管下颌骨罕见放线菌病是可治愈的，但应列入颌骨骨髓炎的鉴别诊断中。早期准确诊断和及时干预可确保更好的治疗效果。
