Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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A diagnostic dilemma in pediatric osteomyelitis: a case report

  • Mandrekar, Pooja Narendra (Department of Oral and Maxillofacial Surgery, Goa Dental College & Hospital) ;
  • Gavhane, Sanket (Department of Oral and Maxillofacial Surgery, Goa Dental College & Hospital) ;
  • Fernandes, Trishala Bhadauria (Department of Oral and Maxillofacial Surgery, Goa Dental College & Hospital) ;
  • Dhupar, Vikas (Department of Oral and Maxillofacial Surgery, Goa Dental College & Hospital) ;
  • Dhupar, Anita (Department of Oral and Maxillofacial Pathology, Goa Dental College & Hospital)
  • Received : 2021.03.07
  • Accepted : 2021.07.19
  • Published : 2022.04.30
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Abstract

Infantile osteomyelitis is a rare disease that is infective in nature and may rapidly turn fatal, as the disease is often misdiagnosed due to its varied presenting signs. Early diagnosis may help in avoiding systemic involvement and permanent deformity. The disease presents with signs of orbital involvement, nasal congestion, and emesis, as well as other standard hallmarks of infection. Furthermore, the maxilla is a highly vascular and porous bone and the occurrence of osteomyelitis in an infant maxilla is highly uncommon. In addition, routine blood work is not suggestive of the presence of this disease. Thus, prompt diagnosis of this condition poses a challenge to surgeons due to the confusing array of symptoms combined with the rarity of the disease. One such case of osteomyelitis of the maxilla in a young child is presented. The dilemma encountered by the surgeon during the diagnosis and treatment of the disease is discussed.

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References

  1. Dieckmann R, Hardes J, Ahrens H, Flieger S, Gosheger G, Gotze C, et al. [Treatment of acute and chronic osteomyelitis in children]. Z Orthop Unfall 2008;146:375-80. German. https://doi.org/10.1055/s-2008-1038461
  2. Korakaki E, Aligizakis A, Manoura A, Hatzidaki E, Saitakis E, Anatoliotaki M, et al. Methicillin-resistant Staphylococcus aureus osteomyelitis and septic arthritis in neonates: diagnosis and management. Jpn J Infect Dis 2007;60:129-31.
  3. Feng Z, Chen X, Cao F, Lai R, Lin Q. Osteomyelitis of maxilla in infantile with periorbital cellulitis: a case report. Medicine (Baltimore) 2015;94:e1688. https://doi.org/10.1097/MD.0000000000001688
  4. Khullar SM, Tvedt D, Chapman K, Herlofson BB. Sixty cases of extreme osteonecrosis and osteomyelitis of the mandible and maxilla in a West African population. Int J Oral Maxillofac Surg 2012;41:978-85. https://doi.org/10.1016/j.ijom.2012.04.022
  5. Goode-Jolly D, Besson D, Lopez A, Cabanis EA. [A case of acute osteomyelitis of the maxilla in infants. Current prognosis of ocular and dental manifestations]. Bull Soc Ophtalmol Fr 1986;86:1141-4.
  6. Yadav S, Malik S, Mittal HC, Puri P. Chronic suppurative osteomyelitis of posterior maxilla: a rare presentation. J Oral Maxillofac Pathol 2014;18:481. https://doi.org/10.4103/0973-029X.151364
  7. Loh FC, Ling SY. Acute osteomyelitis of the maxilla in the newborn. J Laryngol Otol 1993;107:627-8. https://doi.org/10.1017/s0022215100123916
  8. Skouteris CA, Velegrakis G, Christodoulou P, Helidonis E. Infantile osteomyelitis of the maxilla with concomitant subperiosteal orbital abscess: a case report. J Oral Maxillofac Surg 1995;53:67-70. https://doi.org/10.1016/0278-2391(95)90505-7
  9. Lieberman H, Brem J. Syndrome of acute osteomyelitis of the superior maxilla in early infancy. N Engl J Med 1959;260:318-22. https://doi.org/10.1056/NEJM195902122600704
  10. Wilensky AO. Osteomyelitis of the jaws in nurslings and infants. Ann Surg 1932;95:33-45. https://doi.org/10.1097/00000658-193201000-00003
  11. Scott EP, Rotondo CC. Fracture with osteomyelitis of the mandible in a newborn infant. Am J Dis Child 1946;72:411-4. https://doi.org/10.1001/archpedi.1946.02020330043006
  12. Sanders B. Pediatric oral and maxillofacial surgery. St. Louis (MO): Mosby; 1979:195.
  13. Thoma KH. Oral surgery. 5th ed. St. Louis (MO): Mosby; 1969:781.
  14. Davis CH. Davis' gynecology and obstetrics. Vol. 2. Hagerstown (MD): W. F. Prior Company; 1940:31.
  15. Kang HJ, Lee JH, Kim YD, Byun JH, Shin SH, Kim UK, et al. Osteomyelitis occuring in the zygoma caused by odontogenic maxillary sinusitis - case report. J Korean Assoc Oral Maxillofac Surg 2004;30:251-4.
  16. Street M, Puna R, Huang M, Crawford H. Pediatric acute hematogenous osteomyelitis. J Pediatr Orthop 2015;35:634-9. https://doi.org/10.1097/BPO.0000000000000332