Deliverska Elitsa G, Yovchev Dimitar T, Genadieva Marusia Zh, Parusheva Sadeta J
Department of Dental, Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria.
Department of Imaging and Oral Diagnostics, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria.
Case Rep Dent. 2025 Jan 4;2025:6211159. doi: 10.1155/crid/6211159. eCollection 2025.
Actinomycosis is a rare chronic granulomatous infection and can be caused by Gram-positive anaerobic bacteria which are normal commensals of the oral cavity and pharynx. These organisms can involve different parts of the maxillofacial region, rarely affecting the jaws. Actinomycotic osteomyelitis is an infection of the jaw bones, typically associated with trauma or an underlying nonspecific infection or disease. Herein, we describe a rare case of actinomycotic osteomyelitis of the mandible in a healthy male patient. Comprehensive surgical treatment with curettage and peripheral ostectomy was performed. The diagnosis was made on the basis of clinical findings and the histological result. Antibiotic treatment from the penicillin group was prescribed for a period of 1 month. Diagnosis is often delayed and can be a challenge for clinical practice due to the lack of criteria other than definitive histopathological examination. A chronic clinical course without regional lymphadenopathy may be essential in the diagnosis. A number of diseases can present with similar symptoms, necessitating strict adherence to a correct surgical protocol; even when such an infection is suspected, histopathological examination is essential, and long-term treatment with penicillin is advised for accurate treatment of actinomycotic infection.
放线菌病是一种罕见的慢性肉芽肿性感染，可由革兰氏阳性厌氧菌引起，这些细菌是口腔和咽部的正常共生菌。这些微生物可累及颌面区域的不同部位，很少影响颌骨。放线菌性骨髓炎是颌骨的一种感染，通常与创伤或潜在的非特异性感染或疾病有关。在此，我们描述了一名健康男性患者罕见的下颌骨放线菌性骨髓炎病例。进行了刮除术和周边骨切除术的综合手术治疗。诊断基于临床发现和组织学结果。给予青霉素类抗生素治疗1个月。由于除了明确的组织病理学检查外缺乏其他标准，诊断往往会延迟，并且可能给临床实践带来挑战。慢性临床病程且无区域淋巴结病可能是诊断的关键。许多疾病可能表现出相似的症状，因此必须严格遵循正确的手术方案；即使怀疑有这种感染，组织病理学检查也是必不可少的，建议长期使用青霉素治疗以准确治疗放线菌感染。
