Actinomycosis osteomyelitis of the mandible in a 71-year-old patient: A Case Report

We herein present the treatment of an actinomycosis osteomyelitis case. A 71-year-old female with a dental history of multiple tooth extractions two years prior who subsequently developed chronic osteomyelitis. Previous treatment included 10 sessions of hyperbaric oxygen and pentoxifylline tocopherol protocol as well as debridement of the lesion that had resulted in a subsequent midline pathological fracture of the mandible. The fracture was treated by intra-bony wiring. The clinical extra-oral presentation was that of severe pain, recurrent swelling of the submandibular areas bilaterally and draining fistulae. Our treatment included antibiotic therapy: guided by Microscopy Culture and Sensitivity and a segmental mandibulectomy with the placement of a reconstruction plate. The outcome of the therapeutic management was successful. Histopathology results confirmed chronic osteomyelitis with bacterial colonies in keeping with actinomycosis. At the six-week post-operative appointment, the patient was healing well.