Actinomycosis

Actinomycosis is a chronic infection, commonly of the face and neck, that produces abscesses and open draining sinuses.

Alternative Names

Lumpy jaw

Causes, incidence, and risk factors

Actinomycosis is usually caused by an anaerobic (disliking oxygen) bacterium called Actinomyces israelii . This is a common and normally nonpathogenic (not disease-causing) organism found in the nose and throat. Its normal location in the nose and throat account for actinomycosis, most commonly appearing in the face and neck. Because this organism is normal for people, the infection is not contagious. Actinomyces produces disease when it is introduced into the facial tissues by trauma, surgery, or infection. A common cause is dental abscess or oral surgery. Once in the tissue it forms an abscess , producing a hard red to reddish purple lump, often on the jaw, from which comes the name lumpy jaw. Eventually, the abscess breaks through the skin surface to produce a draining sinus tract. Actinomycosis may occasionally occur in the chest ( pulmonary actinomycosis ) and abdomen or other areas of the body.

Signs and tests

  • Examination of drained fluid under a microscope demonstrates "sulfur granules" in the fluid
  • Examination under a microscope shows the presence of Actinomyces species of bacteria
  • A culture of the tissue or fluid shows Actinomyces species
  • Treatment

    Treatment for actinomyces is long term, with 1 to 2 months of penicillin given through a vein, followed by 6 to 12 months of penicillin taken by mouth. Other drugs have also been effective. Note: Doxycycline is usually not prescribed for children until after all the permanent teeth have erupted. It can permanently discolor teeth that are still forming. Surgical drainage of the lesion may be required.

    Expectations (prognosis)

    Full recovery is expected with treatment.

    Complications

    Meningitis can develop from this infection.

    Calling your health care provider

    Call your health care provider if you develop any of the symptoms of this disorder. Beginning treatment promptly helps quicken the recovery.

    Prevention

    Maintain good oral hygiene . See your dentist regularly.

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