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累及下颌骨髁突的原发性结核性骨髓炎——病例报告

Primary Tubercular Osteomyelitis Affecting the Mandibular Condyle - A Case Report.

作者信息

Gupta Aishwarya Ashok, Jadhav Anendd A, Bhola Nitin D, Mishra Apoorva S, Simre Saurabh Sunil

机构信息

Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India.

出版信息

Ann Maxillofac Surg. 2022 Jan-Jun;12(1):106-109. doi: 10.4103/ams.ams_301_21. Epub 2022 Aug 16.

Abstract

RATIONALE

Primary orofacial tuberculosis (TB) accounts for <3% of all cases of TB. TB of the mandibular condyle is often misdiagnosed owing to its rarity.

PATIENT CONCERNS

This report presents a 19-year-old female who presented with a painful swelling over the right preauricular region. The radiographic evaluation suggested a diagnosis of suppurative osteomyelitis of the condyle.

DIAGNOSIS

Clinically, the aetiology of the swelling was considered as infective. The histopathological examination of the resected specimen showed tuberculous granuloma and the polymerase chain reaction came positive.This confirms the diagnosis of tubercular osteomyelitis. Mantoux test and sputum acid-fast bacilli were found to be negative.

TREATMENT

The patient was subjected to sequestrectomy with high condylectomy and systemic multidrug antitubercular regimen for 6 months.

OUTCOMES

There was a resolution of infection postoperatively with subsequent regeneration of healthy bone.

TAKE-AWAY LESSONS: Early identification and prompt diagnosis is imperative for better treatment outcomes.

摘要

理论依据

原发性口腔面部结核(TB)占所有结核病病例的比例不到3%。由于下颌髁突结核罕见,常被误诊。

患者情况

本报告介绍了一名19岁女性,其右耳前区域出现疼痛性肿胀。影像学评估提示诊断为髁突化脓性骨髓炎。

诊断

临床上,肿胀的病因被认为是感染性的。切除标本的组织病理学检查显示结核性肉芽肿,聚合酶链反应呈阳性,这证实了结核性骨髓炎的诊断。结核菌素试验和痰抗酸杆菌检查均为阴性。

治疗

患者接受了死骨切除术和高位髁突切除术,并进行了为期6个月的全身多药抗结核治疗。

结果

术后感染得到解决,随后健康骨再生。

经验教训

早期识别和及时诊断对于获得更好的治疗效果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faaa/9527840/6fa1fd98f907/AMS-12-106-g001.jpg

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