BMJ Case Reports 2012; doi:10.1136/bcr-2012-006218
  • Rare disease

Periapical actinomycosis

  1. Preeti P Nair4
  1. 1Department of Oral & Maxillofacial Surgery, Sri Manakula Vinayaka Medical College, Pondicherry, India
  2. 2Department of Conservative Dentistry, Karpaga Vinayagar Institute of Dental Sciences, Kanchipuram, Tamil Nadu, India
  3. 3Department of Oral Medicine & Radiology, Meenakshiammal Dental College, Chennai, Tamil Nadu, India
  4. 4Department of Oral Medicine & Radiology, People's College of Dental Sciences & Research Centre, Bhopal, Madhya Pradesh, India
  1. Correspondence to Professor Preeti P Nair, shajihoss{at}


Actinomycosis is a rare chronic infection caused by species of Actinomyces and characterised by abscess formation, tissue fibrosis, suppurative lesions and fistulas with purulent discharge containing sulphur granules. Owing to its multiform manners of presentation and non-specificity from its clinical features, it has been considered as a challenging diagnosis. Periapical actinomycosis is one of the rarest forms of actinomycosis occurring in the maxillofacial region. In its occurrence it presents in the form of persistent and recurrent draining fistula in the periapical region. We report a case of periapical actinomycosis occurred in endodontically treated teeth and accidentally found to be actinomycosis during histopatological examination. An insight towards the portal of entry of the organisms into the periapical region is also discussed. The practice of sending even a tiny bit of tissues to histopathology obtained from periapical surgery will very well demonstrate this disease and help in rapid resolution through appropriate antibiotic therapy.

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