Actinomycosis (“Lumpy Jaw”) | Figure 4.13
A: Actinomycosis
(Courtesy of Dr. Paul Getz)
B: Actinomycosis, chest
(Courtesy of Dr. Vandana ehta,
India)
C: Actinomycetoma, arm
(Courtesy of Dr. Paul Getz)
D: Green nail syndrome |
(Figure 4.13A, B) - Due to Actinomyces israelii, an anaerobic filamentous Gram-positive bacteria; part of normal oral flora
- Risk factors: poor dental hygiene, dental procedures, traumatic injuries
- Presents as a firm nodule or bluish swelling at angle of jaw → direct spread into adjacent tissues → formation of fistulas discharging purulent material with granules (yellow sulfur-like appearance consisting of masses of bacteria, both gram-negative and gram-positive)
- Treatment: intravenous PCN initially, then switch to oral PCN × 6–12 months
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