Alternative Names: Lumpy jaw

Causes, incidence, and risk factors:

Actinomycosis is usually caused by an anaerobic (disliking oxygen) bacterium called Actinomyces israelii, which is a common and normally nonpathogenic (not disease-causing) organism found in the nose and throat.

Because of the bacterium's normal location in the nose and throat, actinomycosis most commonly appears in the face and neck. And since it is normal for people to carry this organism, the infection is not contagious.

Actinomyces produces disease when it is introduced into the facial tissues by trauma, surgery, or infection. A common cause is dental abscess or oral surgery. Once in the tissue, it forms an abscess, producing a hard, red-to-reddish-purple lump, often on the jaw, from which comes the condition's common name, "lumpy jaw."

Eventually, the abscess breaks through the skin surface to produce a draining sinus tract. Actinomycosis may occasionally occur in the chest (pulmonary actinomycosis) and abdomen or other areas of the body.

Symptoms:

• A swelling or hard, red-to-reddish-purple lump on the face or upper neck (see neck lumps)
• Fever
• Weight loss
• Pain is minimal to absent
• Draining sores in the skin, particularly those on the chest wall resulting from lung infection with Actinomyces

Signs and tests:

• Examination of drained fluid under a microscope shows "sulfur granules" in the fluid. They are yellowish granules composed of clumped organisms.
• Examination under a microscope shows the presence of Actinomyces species of bacteria
• A culture of the tissue or fluid shows Actinomyces species.

Treatment:

Treatment for actinomycosis is long-term, with 1-2 months of penicillin given through a vein, followed by 6-12 months of penicillin taken by mouth. Other drugs have also been effective.

Note: Doxycycline is usually not prescribed for children until after all the permanent teeth have erupted. It can permanently discolor teeth that are still forming.

Surgical drainage of the lesion may be required.

Support Groups:

Expectations (prognosis):

Full recovery is expected with treatment.

Complications:

Meningitis can develop from this infection.

Calling your health care provider:

Call your health care provider if you develop any of the symptoms of this disorder. Beginning treatment promptly helps quicken the recovery.

Prevention:

Maintain good oral hygiene. See your dentist regularly.