Actinomycosis of the mandible
Naveen Sharma, Seema Singh, Devendra Kumar Ravi, Mohan Kumar and Manoj Pandey
World Journal of Pathology 2012, 1:10
Introduction: Actinomycosis is a rare, slow, progressive disease that mimics neoplasia. Actinomycosis infections of the bone are even rarer and are seen mostly in immunocompromised patients.
Case presentation: A 50 year old male underwent total glossectomy with vein preserving neck dissection and pectoralis major myocutaneous flap reconstruction through a lateral mandibulotomy approach followed by external beam radiotherapy for T3N0M0 carcinoma of the anterior tongue. Two years later he developed an orocutaneous fistula with exposure of dead mandibular bone. The dead bone was excised and histopathology revealed it to be actinomycosis, patient was started on oral penicillin and is disease free at present.
Conclusion: Osteonecrosis of the mandible is a rare complication of radiotherapy and bisphosphonate therapy. Super infection with actinomycosis is rare. Removal of the dead bone and treatment with oral penicillin is the treatment of choice.