Infectious Disease Compendium

Lumpy Jaw

Diagnosis

A woody jaw (it really does feel like balsa wood) that may or may not be draining 'sulfur granules'.

Epidemiologic Risks

Poor dentition. The organism tends to invade through tissue planes, with fistulous tracks, swelling, and drainage.

Actinomyces spp. are appear to be involved in the pathogenesis of bisphosphonate severe osteonecrosis of the jaw (PubMed).

Microbiology

Actinomycosis. Usually, Actinomyces israelii or A. gerencseriae but others have been isolated.

Empiric Therapy

Penicillin/Amoxicillin OR doxycycline OR erythromycin OR clindamycin all po. Therapy is often needed for a year. And all at high dose.

Pearls

It can also be a problem in dogs, horses (PubMed), cattle (the original case report) and other animals.

"In 1890, Eugen Bostroem isolated the causative organism from a culture of grain, grasses, and soil. After Bostroem's discovery, a general misconception existed that actinomycosis was a mycosis that affected individuals who chewed grass or straw (PubMed). "

Last Update: 11/03/18.