Kalaiarasi Raja, Vijayakumar Chellappa, Archana Ramalingam, Natarajan Ramalingam
Otorhinolaryngology, Sri Lakshmi Narayana Institute of Medical Science, Puducherry, India.
Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Cureus. 2018 Jan 15;10(1):e2071. doi: 10.7759/cureus.2071.
Tuberculosis (TB) is a worldwide public health problem; however, primary tuberculous osteomyelitis involving the mandible is extremely rare. Here, we report a 14-year-old boy who presented with a recurrent, generalized swelling of the cheek in the right side, mimicking parotitis. Fine needle aspiration cytology (FNAC) from the swelling was inconclusive. Contrast-enhanced computed tomography (CECT) of the head and neck revealed an osteolytic lesion of the mandible with a surrounding abscess. An intraoral incisional biopsy of the tissue showed a granulomatous lesion. The patient was started on anti-tubercular therapy (ATT) for six months. Our patient's presentation underscores the clinical difficulty in establishing a diagnosis and considering tuberculous osteomyelitis in the differential diagnosis.
结核病是一个全球性的公共卫生问题;然而,累及下颌骨的原发性结核性骨髓炎极为罕见。在此,我们报告一名14岁男孩,他出现右侧脸颊反复性、全身性肿胀,类似腮腺炎。对肿胀部位进行细针穿刺抽吸细胞学检查(FNAC)结果不明确。头颈部增强计算机断层扫描(CECT)显示下颌骨有溶骨性病变并伴有周围脓肿。对该组织进行口腔内切开活检显示为肉芽肿性病变。患者开始接受为期六个月的抗结核治疗(ATT)。我们患者的表现突出了在诊断过程中以及在鉴别诊断中考虑结核性骨髓炎时所面临的临床困难。