Commonly seen in cattle or other livestock and less often in humans, lumpy jaw is an infectious bacterial disease that can produce abscesses anywhere in the body, but typically produces them in the face and neck, lungs, gastrointestinal, or pelvic regions. The infection, also known as actinomycosis, becomes chronic because infected individuals may not experience symptoms until the abscesses grow larger or become painful, after surrounding tissue and nerve involvement occurs. Once diagnosed, lumpy jaw treatment generally involves an extended course of antibiotics.
The majority of lumpy jaw cases evolve from an invasion of various Actinomyces bacterial species. These bacteria commonly reside on the surface of the oral cavity and in the cecum of the large intestine without causing harm. Being largely opportunistic, the bacteria only gain access to internal tissues following infection, surgery, or trauma in any of these areas. Actinomycosis in the mouth region might happen because of poor oral hygiene or periodontal disease. The bacteria might also gain access to internal tissue when a person receives dental work.
Appendectomy, infections, or ulcerations in the gastrointestinal tract open the door for Actinomyces invasion. Upper respiratory infections may provide the vehicle for the bacteria to enter the lungs, and if the infection progresses, the bacteria might invade the heart or other areas of the chest cavity. The bacterial disease tends to affect men more frequently than women, but women using intrauterine birth control devices (IUDs) are usually more susceptible to the infection.
Actinomyces proliferates in warm, moist environments with little to no oxygen. As the bacteria colonizes and expands over weeks or months, abscesses develop and cause tissue swelling, appearing as hardened, red or reddish-purple lumps. Left untreated, the abscesses continue growing until they rupture and drain. Symptoms largely depend on what part of the body becomes infected but include fever, discolored hard lumps, and possibly discomfort. Symptoms associated with advanced actinomycosis also usually include open draining sores, pain, and weight loss.
Proper diagnosis generally involves a culture of the draining fluid and microscopic evaluation. Under a microscope, the fluid appears to contain yellow colored clumps, which are the colonies of bacteria. Physicians usually treat the infection with penicillin, doxycycline, or sulfonamide antibiotics. Infected individuals may require hospitalization for intravenous antibiotic treatment, followed by outpatient oral antibiotic therapy for up to one year. Some conditions may require surgical intervention to drain or remove the abscesses, depending on the amount of tissue involved.