Actinomycotic Osteomyelitis of Mandible Masquerading Periapical Pathology

Abstract

ABSTRACT Actinomycosis is an infectious disease characterized by chronic granulomatous and suppurative lesions often caused by Actinomyces group. Actinomycosis has been referred to as the chameleon of head and neck pathology because of its varied clinical picture which can resemble various pathologies ranging from benign infection to metastatic tumour. Nowadays, the diagnosis of the same may be difficult because the number of patients with typical symptoms has decreased, and there is a low success rate in culturing the microorganism. Mandibular osteomyelitis is also underappreciated by many clinicians in their assessment of head and neck infections. Most cases are traced to an odontogenic source, with periapical tooth abscess and posttraumatic or surgical complication as key antecedent events. A case of osteomyelitis of mandible initiated from a vital but peridontally compromised tooth is reported. Radiography of this case revealed bone destruction, and H & E of the biopsied tissue showed branching filaments resembling ray fungus.