amoxicillin-potassium-clavulanate-combination and Actinomycosis--Cervicofacial

Actinomycosis is a rare chronic granulomatous infection caused by Gram-positive, non-acid-fast, anaerobic to microaerophilic bacteria.We report a case of cervicofacial actinomycosis in an 86-year-old woman undergoing immunosuppressive therapy with azathioprine and prednisone for rheumatoid arthritis. She underwent a dental treatment several months earlier. The diagnosis of culture-negative actinomycosis was based on histolopathology findings and the isolation of companion bacteria. The patient was treated with amoxicillin-clavulanic acid for 3 months, which produced complete clearance of her cervicofacial actinomycosis.Our case points out the pitfalls of diagnostic procedures in actinomycosis and the ability of this rare disease to mimic other medical conditions.

Topics: Actinomycosis, Cervicofacial; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Arthritis, Rheumatoid; Azathioprine; Diagnosis, Differential; Female; Humans; Immunocompromised Host; Immunosuppressive Agents; Prednisone

Actinomycotic infections of the cervicofacial region are not uncommon. However, actinomycosis of the tongue is rare. A mass that may mimic both benign and malignant neoplasms can be seen at clinical presentation and may mislead the diagnosis. We report a patient who presented with a tumour-like tongue mass causing speech disturbance, diagnosed as actinomycosis.

Topics: Actinomyces; Actinomycosis, Cervicofacial; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Combined Modality Therapy; Diagnosis, Differential; Female; Humans; Middle Aged; Tongue Diseases; Tongue Neoplasms

Actinomycosis is an uncommon, chronic suppurative granulomatous infection and needs to be considered as a differential diagnosis. A 56-year-old woman with a background of type 2 diabetes mellitus and breast carcinoma was referred to the Oral and Maxillofacial Surgery 2-week wait clinic, regarding a tender sublingual mass and firm erythematous swelling in the right submandibular and submental region. This was slowly progressive and had not responded to oral co-amoxiclav. An orthopantomogram showed a well-defined radiolucency and smaller radiolucent lesions throughout the edentulous right body of the mandible. A contrast-enhanced CT confirmed a right submandibular abscess communicating with cavitating lesions. The differentials included osteomyelitis, bony metastases, multiple myeloma or other cystic lesions. The patient underwent incision and drainage of the abscess, alongside biopsies, and intravenous co-amoxiclav was given. Microbiology cultures confirmed the presence of

Topics: Abscess; Actinomyces; Actinomycosis, Cervicofacial; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Biopsy; Breast Neoplasms; Diagnosis, Differential; Drainage; Female; Humans; Lymphadenopathy; Mandibular Diseases; Middle Aged; Osteomyelitis; Radiography, Panoramic; Treatment Outcome

Human actinomycosis is a rare soft tissue infection caused by Gram-positive, anaerobic bacteria Actinomyces israelii, a commensal of the oral cavity. The major clinical forms of actinomycosis are cervicofacial, thoracic, abdominal and pelvic forms. The cervicofacial region is most commonly affected. Actinomycosis is sometimes difficult to diagnose and it should be borne in mind in the differential diagnosis of numerous infectious and non-infectious diseases. We report a patient who came with tooth pain and extra-oral swelling which later on presented as multiple draining sinuses. Our initial suspicion was dento-alveolar abscess or osteomyelitis. However, a culture of the discharge and subsequent biopsy revealed actinomycetes, confirming cervicofacial actinomycosis, but presenting itself not as the typical 'lumpy jaw'. The patient was successfully treated conservatively with a short but intensive antibiotic course.

Topics: Actinomycosis, Cervicofacial; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Combined Modality Therapy; Diagnosis, Differential; Humans; Male; Middle Aged; Penicillin G; Radiography, Panoramic

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.. 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.. Mandibular actinomycosis is caused by Actinomyces israelii. Lesions if untreated may evolve to osteitis and sequestration. Early diagnosis is crucial.

Topics: Actinomycosis, Cervicofacial; Adult; Amoxicillin-Potassium Clavulanate Combination; Female; Humans; Male; Mandibular Diseases; Middle Aged; Radiography; Young Adult

Apart from neoplastic processes, chronic disfiguring and destructive diseases of the mandible are uncommon.. We report, perhaps for the first time, the simultaneous occurrence of two such conditions in one patient, in a case that emphasizes the importance of bone biopsy in establishing the correct diagnosis. Florid cemento-osseous dysplasia (FCOD) is a chronic, disfiguring condition of the maxillofacial region. This relatively benign disease is primarily observed in middle-aged women of African ancestry. Cervicofacial actinomycosis is an uncommon and progressive infection caused by bacilli of the Actinomyces genus that typically involves intraoral soft tissues but may also involve bone. The accurate diagnosis of actinomycosis is critical for successful treatment. A diagnosis of osteomyelitis caused by Actinomyces bacteria was diagnosed by bone biopsy in a 53 year-old African-American woman with a longstanding history of FCOD after she presented with a new draining ulcer overlying the mandible.. Clinicians should be aware of the possibility of actinomycosis arising in the setting of FCOD, and the importance of bone biopsy and cultures in arriving at a definitive and timely diagnosis.

Topics: Actinomycosis, Cervicofacial; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; beta-Lactams; Denture, Complete, Lower; Drug Combinations; Ertapenem; Female; Fibrous Dysplasia of Bone; Humans; Mandibular Diseases; Middle Aged; Oral Ulcer; Osteomyelitis; Radiography

Infectious diseases transmitted by actinomycosis species cause severe destructive lesions. This rare and specific infection is mainly found in the orofacial regions. Causes of any hard tissue swelling in the jaw have, thus, to be assessed carefully. When actinomycosis is identified, a surgical intervention with curettement, draining and long-term antibiosis is required. The aim of the current article is to describe two clinical cases and to show the necessity of both, microbiological and histological laboratory diagnostics, to hedge the clinic diagnosis.

Topics: Actinomyces; Actinomycosis, Cervicofacial; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Clindamycin; Drainage; Female; Focal Infection, Dental; Humans; Male; Periapical Abscess; Young Adult

Actinomycosis is a rare chronic granulomatous disease that involves the upper airway and gastrointestinal tract. Approximately 40-55% of actinomycosis comprises the cervicofacial form. It presents a challenging clinical diagnostic dilemma because of variable presentations in the head and neck. Herein, we report a rare case of actinomycosis presenting as a vocal cord nodule in a healthy 21-year-old man who was not immunocompromised and had no other known medical disease.

Topics: Actinomycosis, Cervicofacial; Adult; Amoxicillin-Potassium Clavulanate Combination; Biopsy; Diagnosis, Differential; Hoarseness; Humans; Laryngeal Diseases; Laryngoscopy; Male; Postoperative Care; Vocal Cords