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Mandibular Osteomyelitis

History: 60 year old female status post oral surgery one month ago presents with jaw pain.  This patient turned out to have chronic actinomyces osteomyelitis of the mandible with bony sequestrum and fistula formation.

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History: 60 year old female status post oral surgery one month ago presents with jaw pain. 

Fig 1: Single axial CT scan of the mandible with bone windows showing periosteal reaction and sclerotic changes within the parasymphyseal mandible, concerning for acute osteomyelitis.
Fig 1: Single axial CT scan of the mandible with bone windows showing periosteal reaction and sclerotic changes within the parasymphyseal mandible, concerning for acute osteomyelitis.
Fig 2: Single axial CT scan of the mandible in bone windows in the same patient 2 years later shows marked progression of sclerosis of the mandible with interval sequestrum formation. Additionally (not shown), there was fistulization to the oral cavity.
Fig 2: Single axial CT scan of the mandible in bone windows in the same patient 2 years later shows marked progression of sclerosis of the mandible with interval sequestrum formation. Additionally (not shown), there was fistulization to the oral cavity.

This patient turned out to have chronic actinomyces osteomyelitis of the mandible with bony sequestrum and fistula formation.

2 responses to “Mandibular Osteomyelitis”

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