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Actinomycosis

Lumpy jaw

 

Actinomycosis is a long-term (chronic) bacterial infection that commonly affects the face and neck.

Causes

 

Actinomycosis is usually caused by bacterium called Actinomyces israelii. This is a common organism found in the nose and throat. It normally does not cause disease.

Because of the bacteria's normal location in the nose and throat, actinomycosis most commonly affects the face and neck. The infection can sometimes occur in the chest (pulmonary actinomycosis), abdomen, pelvis, or other areas of the body. The infection is not contagious. This means it does not spread to other people.

Symptoms occur when the bacteria enter the tissues of the face after trauma, surgery, or infection. Common triggers include dental abscess or oral surgery. The infection can also affect certain women who have had an intrauterine device (IUD) to prevent pregnancy.

Once in the tissue, the bacteria cause an abscess, producing a hard, red to reddish-purple lump, often on the jaw, from which comes the condition's common name, "lumpy jaw."

Eventually, the abscess breaks through the skin surface to produce a draining sinus tract.

 

Symptoms

 

Symptoms may include any of the following:

  • Draining sores in the skin, especially on the chest wall from lung infection with actinomyces
  • Fever
  • Mild or no pain
  • Swelling or a hard, red to reddish-purple lump on the face or upper neck
  • Weight loss

 

Exams and Tests

 

The health care provider will perform a physical exam and ask about your symptoms.

Tests that may be done to check for presence of the bacteria include:

  • Culture of the tissue or fluid
  • Examination of drained fluid under a microscope

 

Treatment

 

Treatment of actinomycosis usually requires antibiotics for several months to a year. Surgical drainage or removal of the affected area (lesion) may be needed. If the condition is related to an IUD, the device must be removed.

 

Outlook (Prognosis)

 

Full recovery can be expected with treatment.

 

Possible Complications

 

In rare cases, meningitis can develop from actinomycosis.

 

When to Contact a Medical Professional

 

Call your provider if you develop symptoms of this infection. Starting treatment right away helps quicken the recovery.

 

Prevention

 

Good oral hygiene and regular dentist visits may help prevent some forms of actinomycosis.

 

 

References

Brook I. Actinomycosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 329.

Russo TA. Agents of actinomycosis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 256.

Soper DE. Infections of the female pelvis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 111.

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  • Actinomycosis (lumpy jaw)

    Actinomycosis (lumpy jaw...

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    • Actinomycosis (lumpy jaw)

      Actinomycosis (lumpy jaw...

      illustration

     

    Review Date: 12/10/2015

    Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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