[Mandibular actinomycosis]. / L'actinomycose mandibulaire.

INTRODUCTION: Actinomycosis is a rare disease. The cervicofacial region is the most frequent localization. A chronic pus discharge, sometimes tumor-like, suggests the diagnosis, which is often confirmed by anatomopathology. The treatment is surgical debridement and antibiotic therapy, frequently long-term. We report three cases of mandibular actinomycosis. CASE REPORTS: A 21-year-old male patient presented with a fistulized swelling of the right jaw. A 48-year-old male patient was referred for alveolar healing delay after avulsion of teeth 32, 33, and 34. A 38-year-old female patient presented with a left mandibular swelling and restricted mouth opening. In the three cases, the diagnosis of actinomycosis was made by histology. The clinical outcome was good following alveolar curettage (and sequestrectomy for 1 patient) and antibiotic therapy. DISCUSSION: Mandibular actinomycosis is caused by Actinomyces israelii. Lesions if untreated may evolve to osteitis and sequestration. Early diagnosis is crucial.

Actinomycosis of the maxilla - a case report of a rare oral infection presenting in general dental practice.

Actinomycosis is a suppurative and often chronic bacterial infection most commonly caused by Actinomyces israelii. It is rare in dental practice. In the case reported the patient presented to his general dental practitioner complaining of a loose upper denture. This was found to be due to an actinomycotic infection which had caused extensive destruction and sequestration of the maxillary and nasal bones and subsequent deviation of the nasal septum.

Two unusual presentations of cervicofacial actinomycosis and review of the literature.

Cervicofacial actinomycosis is the most common clinical form of actinomycosis. This bacterial infection is rare. Diagnosis is difficult, often it is definitive only after surgical excision of the cervicofacial mass. Personal experience is reported concerning two cases of cervicoactinomycosis. Diagnosis, in both cases, has been based on histological findings, not on clinical symptoms. A review of the literature shows that mainly males are affected by this condition and, in fact, both patients described here are males. Symptoms of acute infection were absent. Both patients denied any history of oromaxillofacial trauma or recent dental extraction or oral manipulations. Imaging techniques--ultrasonography and computerized tomography--were not effective in making the diagnosis, in either of these patients. Furthermore, fine needle aspiration cytology did not provide a definitive diagnosis. Both patients underwent surgical excision of the mass. Penicillin was the drug of choice in post-operative long-term treatment (one month). In one of the two men, intravenous steroids were administered. As in several reports in the literature, the definitive diagnosis was histological and not clinical.

[Actinomycosis of sinus maxillaris--case report]. / Aktinomykoza zatoki szczekowej--opis przypadku.

The authors present the case of primary actinomycosis of maxillary sinus. The frequency of the disease, differential diagnosis and treatment we present.

Dual pathology: cervicofacial actinomycosis and nicorandil-induced oral ulceration.

INTRODUCTION: Oral ulceration has many causes and is a common presenting symptom in otolaryngology. CASE REPORT: This article presents an unusual case of dual pathology oral ulceration in an elderly patient. Oral malignancy was initially suspected, but the history, examination and investigation showed that the oral ulceration was caused by actinomycosis infection and by nicorandil use. DISCUSSION: Cervicofacial acinomycosis is a rare, suppurative bacterial disease in which abscesses can form in the tissues and break through the skin, creating pus-discharging lesions. Nicorandil is a potassium channel blocker used in the treatment of ischaemic heart disease. It has been recently recognised as a cause of persistent ulcerative stomatitis. CONCLUSION: This case highlights the importance of a high index of suspicion for unusual and reversible causes of oral ulceration, and of dual pathology as a cause. Such vigilance enables early recognition and treatment of potentially reversible conditions.

Chronic sinusitis unresponsive to medical therapy: a case of maxillary sinus actinomycosis focusing on computed tomography findings.

Actinomycosis of the paranasal sinuses is a rare occurrence and its clinical presentation does not suggest a specific diagnosis. Therefore, actinomycosis should be included in the differential diagnosis of neoplasms and granulomatous lesions of the head and neck region. However, the differentiation from a malignant neoplasm is not easy because the radiological findings are frequently similar and positive cultures are difficult to obtain. This report highlights the clinical progress of paranasal actinomycosis associated with some computed tomography findings that can be extremely helpful in the correct diagnosis. The characteristics of the disease are described and the relevant literature is discussed.

Actinomicosis cervicofacial / Cervicofacial actinomycosis

Hemos considerado oportuna la presentación de 4 casos clínicos de Actinomicosis Cervicofacial vistos en la Cátedra de Dermatología de la UNT en el período 1999-2000, dada la baja frecuencia de presentación y la confusión con fístulas dentarias. Además queremos destacar la importancia del trabajo multidisciplinario (Odontólogo, Dermatólogo y Micólogo) para solucionar en totalidad el problema. (AU)

[Simultaneous occurrence of cervicofacial an pleuropulmonary actinomycosis]. / Cervicofacialis és pleuropulmonalis actinomycosis együttes elöfordulása.

Successful treatment of rapidly spread cervicofacial and pleuropulmonary actinomycosis case is reported. Significant law destruction and pathological fractures were observed as well.

[Cervicofacial actinomycosis]. / Actinomicosis cervicofacial.

Actinomycosis is an infectious disease that appears throught the world, in cattle and human beings. It is a chronic granulomatous and suppurative lesion, usually affecting the cervicofacial area. Definitive diagnosis, by culture or biopsy, is not always possible, so the clinician must suspect it by its clinical presentation. It is the purpose of this article to present the patients diagnosed and treated in our Department during the last 5 years, and to review the ideal therapy.

Actinomycosis of the vallecula: report of a case and review of the literature.

A rare case of actinomycosis presenting primarily as a mass in the vallecula is described. The patient was a healthy, 65-year-old Saudi, lady who was not immunocompromised and had no other primary pathology in the oral cavity. The clinical presentation and management of the case are discussed and the relevant literature reviewed.

Cranio-facial actinomycosis.

In the National Neurosurgical Centre in the Sultanate of Oman, four patients with cranio-facial actinomycosis were seen over a 5-year period. All patients had osteomyelitis and intracranial granulomata and the diagnosis was confirmed with histopathology. In two cases the organisms were cultured. In three patients the cranial spread was by contiguity from the scalp and face while one case had the extradural granuloma following a dental extraction. With medication there was gross reduction of proptosis and intracranial lesion in one patient and in two there was marked reduction in the size of the intracranial lesion as seen on serial computerized tomographic scanning of the head (CT head). Three patients are now asymptomatic and are being followed up while one expired with subarachnoid haemorrhage. Although eradication of the disease is difficult, with adequate medication and appropriate surgical intervention, three of these patients continue to remain relatively symptom-free for long periods of time.

Actinomycosis: CT findings in six patients.

Actinomycosis is an uncommon disease with clinical and radiographic findings that overlap those of other inflammatory and neoplastic conditions. A retrospective review of CT scans in six proved cases revealed a spectrum of findings, including soft-tissue mass with various degrees of infiltration and abscess formation. Administration of IV contrast material was helpful in defining the loculations of the abscess in two cases. Areas of involvement included the neck (two cases), liver (one case), abdominal wall (one case), thorax (one case) and kidney and retroperitoneum (one case). CT findings of a soft-tissue mass in the neck, lungs, or abdomen, with or without a draining sinus or fistula, raise the possibility of actinomycosis in patients with clinical findings that suggest a subacute or chronic inflammatory process.