Arshad Wajiha, Mahmood Kamal Mahjabeen, Rafique Zunaira, Rahat Manahil, Mumtaz Hassan
Consultant Radiologist, KRL Hospital Islamabad, Pakistan.
Resident Radiologist, KRL Hospital Islamabad, Pakistan.
Ann Med Surg (Lond). 2022 Aug;80:104242. doi: 10.1016/j.amsu.2022.104242. Epub 2022 Jul 31.
and Importance: Maxillary actinomycosis is a persistent, very rare disease produced by Actinomyces species which may include only soft tissue or bone or the two together. Actinomycotic osteomyelitis of maxilla is very infrequent when compared to mandible.
Here we are conferring a case of an elderly male patient who had history of COVID-19 infection 4 months ago, with constant complaint of non-remitting vague pain in the region of maxilla with tooth loosening and extractions. He was given a provisional diagnosis of chronic osteomyelitis of maxilla which was later on proved by histopathology as actinomycotic osteomyelitis.
A saprophytic fungus causes mucor mycosis, and it is quite unusual. Strawberry gingivitis is one of the signs and symptoms. Mucormycosis and post-covid oral maxillofacial problems can be improved with early diagnosis. Oral Mucormycosis should be suspected in individuals with weakened immune systems, uncontrolled diabetes or post-covid instances. Surgery and adequate antibiotic treatment are necessary to treat actinomycosis. Infection may return after a period of inactivity, so long-term follow-up is necessary.
We conclude a positive causal association between COVID-19 and actinomycosis. Maxillary osteomyelitis, a very rare infection, and in our case, the causative organism was Actinomyces Patients who have been infected should be tested for Actinomycin, which may masquerade as a head and neck illness.
及其重要性：上颌放线菌病是一种由放线菌属引起的持续性、非常罕见的疾病，可能仅累及软组织或骨骼，或两者同时受累。与下颌骨相比，上颌骨放线菌性骨髓炎非常少见。
在此，我们报告一例老年男性患者，他在4个月前有新冠病毒感染史，持续主诉上颌区域有持续的模糊疼痛，并伴有牙齿松动和拔牙情况。他最初被初步诊断为上颌慢性骨髓炎，后来经组织病理学证实为放线菌性骨髓炎。
腐生真菌引起毛霉菌病，这相当不常见。草莓牙龈炎是其体征和症状之一。早期诊断可改善毛霉菌病和新冠病毒感染后的口腔颌面部问题。免疫系统较弱、糖尿病控制不佳或新冠病毒感染后的个体应怀疑患有口腔毛霉菌病。治疗放线菌病需要手术和充分的抗生素治疗。感染可能在一段时间的静止后复发，因此需要长期随访。
我们得出新冠病毒感染与放线菌病之间存在正相关因果关系的结论。上颌骨髓炎是一种非常罕见的感染，在我们的病例中，致病微生物是放线菌。曾感染过的患者应进行放线菌素检测，因为它可能伪装成头颈疾病。
