title: Mandibular Actinomyces osteomyelitis complicating florid cemento-osseous dysplasia: case report.
abstract: BACKGROUND
  Apart from neoplastic processes, chronic disfiguring and destructive diseases of the mandible are uncommon.
  
  
  METHODS
  We report, perhaps for the first time, the simultaneous occurrence of two such conditions in one patient, in a case that emphasizes the importance of bone biopsy in establishing the correct diagnosis. Florid cemento-osseous dysplasia (FCOD) is a chronic, disfiguring condition of the maxillofacial region. This relatively benign disease is primarily observed in middle-aged women of African ancestry. Cervicofacial actinomycosis is an uncommon and progressive infection caused by bacilli of the Actinomyces genus that typically involves intraoral soft tissues but may also involve bone. The accurate diagnosis of actinomycosis is critical for successful treatment. A diagnosis of osteomyelitis caused by Actinomyces bacteria was diagnosed by bone biopsy in a 53 year-old African-American woman with a longstanding history of FCOD after she presented with a new draining ulcer overlying the mandible.
  
  
  CONCLUSIONS
  Clinicians should be aware of the possibility of actinomycosis arising in the setting of FCOD, and the importance of bone biopsy and cultures in arriving at a definitive and timely diagnosis.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Michigan Medical School, 1150 W. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Miller H
authors.initials: MH
authors.lastname: Smith
authors.forename: Paul W
authors.initials: PW
authors.lastname: Harms
authors.forename: Duane W
authors.initials: DW
authors.lastname: Newton
authors.forename: Bill
authors.initials: B
authors.lastname: Lebar
authors.forename: Sean P
authors.initials: SP
authors.lastname: Edwards
authors.forename: David M
authors.initials: DM
authors.lastname: Aronoff
mesh_terms: D000197:Actinomycosis, Cervicofacial / Q000150:complications* / Q000188:drug therapy; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003826:Denture, Complete, Lower / Q000009:adverse effects; D004338:Drug Combinations; D000077727:Ertapenem; D005260:Female; D005357:Fibrous Dysplasia of Bone / Q000150:complications*; D006801:Humans; D008336:Mandibular Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D008875:Middle Aged; D019226:Oral Ulcer / Q000150:complications / Q000209:etiology / Q000601:surgery; D010019:Osteomyelitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D011859:Radiography; D047090:beta-Lactams / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D047090:beta-Lactams; D019980:Amoxicillin-Potassium Clavulanate Combination; D000077727:Ertapenem