Abstract
Microbiological investigations of specimens from anatomical structures adjacent to the oral cavity are always difficult to interpret concerning the relevance of the bacteria isolated. In case of an osteomyelitis of the jaws the detection of Staphylococcus aureus is often relevant and coagulase-negative staphylococci can be responsible for implant associated infections. Staphylococci are normally not found in the oral cavity; the susceptibility pattern of staphylococci is essential for adequate treatment; however, tissue samples as well as swabs from the infected jaw reveal mostly aerobic and anaerobic bacteria, e.g., viridans streptococci, Eikenella corrodens, peptostreptococci, Fusobacterium spp., and Actinomyces spp. All these bacteria can be innocent bystanders or infectious agents, but are mostly susceptible to clindamycin or amoxicillin−clavulanate; therefore, microbiological investigations are only helpful in case of osteomyelitis of the jaws, if specimens can be taken without contamination from the oral cavity. Furthermore, the laboratory must be informed if specific infections are suspected, e.g., actinomycosis, because selective agar plates must be inoculated and a prolonged incubation time up to 10 days is necessary. In case of a diagnosed primary chronic osteomyelitis of the jaws, interpretation of any isolated bacterium must be done with caution. Nevertheless, if the samples were taken without contamination from the oral cavity, the possible relevance of an unexpected bacterium should not be ignored. In conclusion, routine microbiological investigations of osteomyelitis affecting the jawbone usually do not have a major clinical impact, unless a special clinical situation is present. In such cases, preanalytic precautions, i.e., sampling technique and transport media for anaerobes, must be respected; otherwise, microbiological results are not promising.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Baltensperger MM. A retrospective analysis of 290 osteomyelitis cases treated in the past 30Â years at the Department of Cranio-Maxillofacial Surgery Zurich with special recognition of the classification. Med Thesis, University of Zurich, 2003
Baltensperger M, Grätz K, Bruder E, Lebeda R, Makek M, Eyrich G. Is primary chronic osteomyelitis a uniform disease? Proposal of a classification based on a retrospective analysis of patients treated in the past 30 years. J Craniomaxillofac Surg 2004; 32:43−50
Bernier S, Clermont S, Maranda G, Turcotte JY. Osteomyelitis of the jaws. J Can Dent Assoc 1995; 61:441−448
Brook I. Microbiology and management of deep facial infections and Lemierre syndrome. ORL 2003, 65:117−120
Calhoun KH, Shapiro RD, Stiernberg CM, Calhoun JH, Mader JT. Osteomyelitis of the mandible. Arch Otolaryngol Head Neck Surg 1988; 114:1157−1162
Clover MJ, Barnard JDW, Thomas GJ, Brennan PA. Osteomyelitis of the mandible during pregnancy. Br J Oral Maxillofac Surg 2005; 43:261−263
Eyrich G, Harder C, Sailer HF, Langenegger T, Bruder E, Michel BA. Primary chronic osteomyelitis associated with synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO syndrome). J Oral Pathol Med 1999; 28:456−464
Eyrich G, Baltensperger M, Bruder E, Graetz K. Primary chronic osteomyelitis in childhood and adolescence: a retrospective analysis of 11 cases and review of the literature. J Oral Maxillofac Surg 2003; 61:561−573
Holmberg K. Diagnostic methods for human actinomycosis. Microbiol Sci 1987; 4:72
Hovi L, Saarinen UM, Donner U, Lindquist C. Opportunistic osteomyelitis in the jaws of children on immunosuppressive chemotherapy. J Pediatr Hematol Oncol 1995; 18:90−94
Hudson JW. Osteomyelitis of the jaws: a 50-year perspective. J Oral Maxillofac Surg 1993; 51:1294−1301
Jousimies-Somer HR, Summanen P, Citron DM, Baron EJ, Wexler HM, Finegold SM. Wadsworth-KTL Anaerobic bacteriology manual, 6th edn. Star Publishing Company, California, 2002
Jousimies-Somer HR, Summanen PH, Wexler HM, Finegold SM, Gharbia SE, Shah HN. Bacteroides, Porphyromonas, Prevotella, Fusobacterium, and other anaerobic Gram-negative bacteria. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH (eds) Manual of clinical microbiology, 8th edn. ASM Press, Washington D.C., 2003, pp 880−901
Kahn MF, Hayem F, Grossin M. Is diffuse sclerosing osteomyelitis of the mandible part of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome? Analysis of seven cases. Oral Surg Oral Med Oral Pathol 1994; 78:594−598
Kugler KC, Biedenbach DJ, Jones RN. Determination of the antimicrobial activity of 29 clinically important compounds tested against fastitidious HACEK Group organisms. Diagn Microbiol Infect Dis 1999; 34:73−76
Lambert FW Jr, Brown JM, George LK. Identification of Actinomyces isarelii and Actinomyces naeslundii by fluorescent antibody and agar gel diffusion techniques. J Bacteriol 1967; 94:1287
Loh FC, Ling SY. Acute osteomyelitis of the maxilla in the newborn. J Laryngol Otol 1993; 107:627−628
Marx RE. Chronic osteomyelitis of the jaws. Oral Maxillofac Surg Clin North Am 1991; 3(2):367−381
Marx RE, Carlson ER, Smith BR, Toraya N. Isolation of Actinomyces species and Eikenella corrodens from patients with chronic diffuse sclerosing osteomyelitis. J Oral Maxillofac Surg 1994; 52:26−33
Marx RE. Discussion. Diffuse sclerosing osteomyelitis of the mandible. Its characteristics and possible relationship to synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome. J Oral Maxillofac Surg 1996; 54:1199−2000
Moncla BJ, Hillier SL. Peptostreptococcus, Propionibacterium, Lactobacillus, Actinomyces, and other non-spore-forming anaerobic Gram-positive bacteria. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH (eds) Manual of clinical microbiology, 8th edn. ASM Press, Washington D.C., 2003, pp 857−879
Peterson LR, Thomson RB Jr. Use of the clinical microbiology laboratory for the diagnosis and management of infectious diseases related to the oral cavity. Infect Dis Clin North Am 1999; 13:775−795
Ruoff KL, Whiley RA, Beighton D. Streptococcus. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH (eds) Manual of clinical microbiology, 8th edn. ASM Press, Washington D.C., 2003, pp 405−421
Russo TA. Agents of actinomycosis. In: Mandell GL, Bennett JE, Dolin R (eds) Principles and practice of infectious diseases 6th edn. Elsevier Churchill Livingstone, Philadelphia, 2005, pp 2924−2934
Scolozzi P, Lombardi T, Edney T, Jaques B. Enteric bacteria mandiular osteomyelitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99:E42−E46
Topazian RG. Osteomyelitis of the jaws. In: Topizan RG, Goldberg MH, Hupp JR (eds) Oral and maxillofacial infections, 4th edn. Saunders, Philadelphia, 2002, pp 214−242
Tzianabos AO, Kasper DL. Anaerobic infections: general concepts. In: Mandell GL, Bennett JE, Dolin R (eds) Principles and practice of infectious diseases 6th edn. Elsevier Churchill Livingstone, Philadelphia, 2005, pp 2810−2816
Wilson M. Microbial inhabitants of humans. Their ecology and role in health and disease. Cambridge University Press, UK, 2005
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Zbinden, R. (2009). Microbiology. In: Baltensperger, M., Eyrich, G. (eds) Osteomyelitis of the Jaws. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-28766-7_7
Download citation
DOI: https://doi.org/10.1007/978-3-540-28766-7_7
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-28764-3
Online ISBN: 978-3-540-28766-7
eBook Packages: MedicineMedicine (R0)