Abstract

Background: Actinomycosis is a rare, painless, indolent, granulomatous infection caused by Actinomyces spp. The varied clinical presentation often can be misdiagnosed which can later lead to complications. Involvement of the oral cavity can mimic a gingival or periodontal abscess. This article presents a clinical case of actinomycosis in the posterior maxilla with not-so-pathognomic clinical presentation but a complete successful resolution of the infection.

Methods: A 36-year old male patient presented with mobile tooth and difficulty in mastication, without pain. Intraoral examination and periapical radiograph was done for the affected tooth no. 26. Surgical extraction and debridement was carried out under local anaesthesia. Bone graft was placed and the surgical site was covered with buccal advancement flap. Patient was put on Amoxycillin (875 mg) + clavulanic acid (125 mg) twice a day for a period of 5 days. After the histopathological examination confirmed the diagnosis of Actinomycosis, the antibiotic regime was prolonged for another five weeks. Case reports on actinomycosis were searched on Google Scholar and other databases. Summarisation of data and evaluation was carried out according to a critical appraisal checklist for case reports.

Results: Satisfactory post operative healing of the surgical site was noted after six weeks of follow up. Intra oral peri-apical radiograph revealed increased bone height below the floor of maxillary sinus after antibiotic therapy for a period of 6 weeks.

Conclusion: The surgical curettage of the extraction socket along with long term penicillin therapy is quintessential for the best outcome.

Keywords: actinomycosis, antibiotic, giant cells, graft, granuloma, maxilla.