A 29 year old woman with jaw swelling

A 29 year otherwise healthy woman presented with left jaw swelling since 1 month. She had a history of multiple dental procedures including dental extraction and root canal treatments since 3 years. Symptoms started with a right jaw swelling 4 months prior which regressed after a course of oral antibiotics. A radiograph of the lower jaw was normal. A CT scan revealed a hypodense ill defined lesion in the lower jaw. Biopsy of the lesion revealed subacute inflammation. Gram positive filamentous bacteria identified to be Actinomyces species were isolated from bacterial cultures of the biopsied samples.

The patient was started on intravenous ceftriaxone for 2 weeks followed by an extended course of oral amoxicillin.

Actinomycosis of the jaw following dental procedures