Aktinomykose – infektion i relation til underkæbens tredjemolar. Præsentation af et patienttilfælde
På baggrund af og som supplement til oversigtsartiklen »Aktinomykose - med særligt henblik på tandlægepraksis« der bragtes i Tandlægebladet 2007; 111: 356, bringes i det følgende en præsentation af et patienttilfælde med infektion af Actinomyces omkring en tredjemolar i underkæben. Det radiologiske billede ved lokal infektion er ofte uspecifikt. Såfremt det kliniske billede er unormalt med inficeret bindevæv perikoronalt eller som i nærværende tilfælde i en kavitet, kan det være relevant at foretage histologisk undersøgelse for at udelukke aktinomykose. En ubehandlet infektion med Actinomyces kan sprede sig til dybere lokalisationer og kan i særlige tilfælde være livstruende.
Actinomycosis – infection related to an impacted lower third molar. A case report: Actinomycosis is a chronic suppurative infection caused by microorganisms from the Actinomyces group. Common signs and symptoms of infection, i.e. pain, swelling, erythema, edema and suppuration are not always present. It is, although often cultured in the healthy normal host, currently an uncommon diagnosed human disease, most often related to local trauma. A case of a 48-year-old man with actinomycosis associated with an osseous lesion around an impacted lower third molar is presented. Symptoms were few and presented as pericoronitis with inflammation of the gingival pad. Upon removal of tooth -8 only scarse amounts of granulation tissue was found in the cavity. The clinical appearance of the surgical site warranted biopsy. Histological examination revealed infection with Actinomyces . Antibiotic treatment was initiated. Penicillin 1MIEx3 for 28 days was administered. Following a period of ten weeks after surgery complete healing was observed. In cases with local infection with Actinomyces the treatment of choice is still a combination of antibiotic medication and surgical removal of infectious foci.
