Maxillary Periapical Actinomycosis: A Case with an Unusual Roentgenographic Appearance

Actinomycosis was once a fairly common disease and one that has a long history . "It was undoubtedly observed early in the 19th Century, as actinomycotic lesions were described erroneously in 1826 by LeBlanc as osteosarcomas and later in the 1800s Bollinger (1876) first recognized it as a specific entity which he named 'lumpy jaw.' " 1 The most frequent clinical form of actinomycosis is the cervicofacial type which is seen in 60% of reported cases, the other forms being abdominal (20% ), pulmonary (15%), and cutaneous (5%).2 Young adult males are most frequently affected with actinomycosis.3 The actinomycetes, the so-called "higher" bacteria, are among the more common microorganisms found within the oral cavity'; however, they seldom exist as pathogens within the oral cavity, and Goldstein et al (1972)5 report that there are fewer than 50 cases of actinomycosis of the maxilla reported in the English literature. Periapical actinomycosis is seen even less frequently. Browne and O'Riordan6 reported a case of periapical actinomycotic granuloma and found that only ten such cases were on record before 1966. In 1975 Samanta et aF reported that the analysis of cases reported subsequently to those of Browne and O'Riordan revealed only five additional cases in