Cervicofacial actinomycosis of the mandible in a paediatric patient

Mandibular Actinomycosis Disguised as a Periapical Lesion

Actinomycosis is a rare chronic suppurative granulomatous disease caused by commensal bacteria of Actinomyces species. We report an unusual case of a 20-year-old male patient presenting with pain and swelling to the right lower posterior teeth for a few months. Radiographs revealed a well-defined osteolytic lesion extending from the periapical region of the right mandibular first premolar to the right mandibular second molar. Based on the clinical history of symptoms, a presumptive diagnosis of more commonly appearing jaw lesions like odontogenic cyst/tumor was made. Incision biopsy resulted in an unexpected diagnosis of Actinomycosis, confirmed with Gram stain and Gomori's Methenamine Silver stain. The patient was treated with long-term antibiotics, and follow-up showed a positive response. This article emphasizes the role of histopathology in avoiding the misdiagnosis of such cases.

Metagenomic analysis of a throat swab sample collected in China on a patient infected with Varicella Zoster Virus

Varicella Zoster Virus (VZV) is endemic worldwide, causing varicella in children and zoster upon reactivation in adults. This study concerned a metagenomic analysis of a throat swab sample collected in China, on a young patient suffering from Systemic Lupus Erythematosus (SLE) and diagnosed with varicella. The complete genome sequence of a VZV strain of clade 2 has been generated. Clade 2 strains are the most prevalent in Asian countries. A comparison of 223 VZV genomes identified 77 clade specific markers, 20 of them specific to clade 2. The metagenomic analysis also identified sequences covering most of the genome of the bacteria Schaalia odontolytica also known as Actinomyces odontolyticus. VZV infection and bacterial infection in the context of SLE is further discussed. Even though the patient presented only mild symptoms, this study is a reminder that vaccination against VZV is critical to avoid severe complications like bacterial superinfection or even death in the case of immunodeficiency.