Virchows Archiv

, Volume 451, Issue 6, pp 1009–1017 | Cite as

Actinomycosis of the jaws—histopathological study of 45 patients shows significant involvement in bisphosphonate-associated osteonecrosis and infected osteoradionecrosis

  • Torsten Hansen
  • Martin Kunkel
  • Erik Springer
  • Christian Walter
  • Achim Weber
  • Ekkehard Siegel
  • C. James Kirkpatrick
Original Article


Actinomycosis of the jaws is a rare disease, which has been recently described in patients with infected osteoradionecrosis (IORN) and bisphosphonate-associated osteonecrosis (BON). We investigated our archive material for Actinomycosis of the jaws with special regard to underlying disease. Out of a total number of 45 patients with Actinomycosis, 43 (93.5%) suffered from BON (58.7%) or IORN (35.6%), while there were only 3 patients (6.7%) without anti-tumor treatment. In all cases, we found direct association of Actinomyces colonies with bone; in the surrounding medullary space, mixed inflammatory infiltrates with variable amounts of osteoclasts were a typical finding. Pseudoepitheliomatous hyperplasia occurred in 60.9% of patients. Cell-rich vessel obliteration was seen in less than 25.9% of BON patients, while hyalinized vessel obliteration was obtained in 37.5% of IORN patients. Additionally performed polymerase chain reaction (PCR) on paraffin-embedded and ethylene diamine tetracetic acid (EDTA)-decalcified tissue specimens confirmed the presence of Actinomyces israelii in seven of seven cases analyzed. We conclude that Actinomycosis of the jaws is a particular complication in patients with BON and/or IORN. Patients with Actinomycosis of the jaws during or after these forms of anti-cancer therapy are suggested to represent a distinct patient cohort with a relevant impairment of their general condition.


Actinomycosis Osteomyelitis Bisphosphonate-associated osteonecrosis Infected osteoradionecrosis Polymerase chain reaction 


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Torsten Hansen
    • 1
  • Martin Kunkel
    • 2
  • Erik Springer
    • 1
  • Christian Walter
    • 2
  • Achim Weber
    • 3
  • Ekkehard Siegel
    • 4
  • C. James Kirkpatrick
    • 1
  1. 1.Institute of PathologyUniversity of MainzMainzGermany
  2. 2.Clinic for Maxillofacial SurgeryUniversity of MainzMainzGermany
  3. 3.Department of Pathology, Institute of Surgical PathologyUniversity Hospital ZurichZurichSwitzerland
  4. 4.Institute of MicrobiologyUniversity of MainzMainzGermany

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