2018 Volume 64 Issue 3 Pages 159-164
Osteomyelitis of the mandible commonly occurs in the mandibular body and is rarely seen in the mandibular condyle. We report a case of actinomycotic osteomyelitis extending from the mandibular ramus to the condyle in a child. A 15-year-old girl was referred to our hospital because of swelling and pain in the left buccal region. Computed tomography (CT) revealed bone resorption and periosteal reaction from the left temporomandibular joint region to the mandibular notch and coronoid process. Based on the CT and magnetic resonance imaging findings, we suspected actinomycotic osteomyelitis of the mandible and then administered penicillin. An abscess was detected in the left parotid masseter region after starting penicillin administration, and necrotic tissue debridement was performed. A group of actinomycetes was identified in the sampled specimen. New bone formation was observed on post-treatment CT, and 99m Tc bone scintigraphy uptake was reduced. Antibiotic treatment was therefore discontinued after approximately 5 months. The patient is currently recovering well without any signs or symptoms of recurrence
