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累及一名儿科患者的牙槽骨放线菌病:诊断与保守治疗

Alveolar Bone Actinomycosis Affecting a Pediatric Patient: Diagnosis and Conservative Management.

作者信息

Reyes Magdalena Raquel Torres, Martins Karina Helen, Torres Carolina Paes, Ribeiro Bruna Campos, Trivelatto Alexandre Elias, León Jorge Esquiche

机构信息

Department of Pediatric Dentistry, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil.

Oral and Maxillofacial Surgery Resident. Oral and Maxillofacial Surgery Residency Program, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4862-4865. doi: 10.1007/s12070-024-04911-5. Epub 2024 Jul 25.

Abstract

Actinomycosis is a rare infection that involves soft and bone tissues caused by gram-positive, anaerobic filamentous bacteria, usually . About 3% of all cases affect children. Not uncommonly, actinomycosis is initially diagnosed as neoplasm or other granulomatous diseases. Paediatric actinomycosis affecting the jaws is rare. To date, 20 and 1 case affecting the mandible and maxilla, respectively, have been reported. A 4-year-old girl was referred presenting an extensive symptomatic ulcerative lesion with bone exposure in the posterior region of the right maxilla two months ago. One month before, she has been diagnosed with scarlet fever. The lesion progressed, damaging the supporting periodontal tissue. After surgical removal of necrotic bone and deciduous molar, the microscopy revealed actinomycosis, which showed excellent healing after local treatment with hydrogen peroxide solution and adequate oral hygiene. Although actinomycosis of the jaws affecting pediatric patients is rare, paediatric dentists must be aware of their clinicopathological characteristics, with therapeutic and prognostic impact.

摘要

放线菌病是一种罕见的感染性疾病,通常由革兰氏阳性厌氧丝状细菌引起,可累及软组织和骨组织。所有病例中约3%发生于儿童。放线菌病最初常被误诊为肿瘤或其他肉芽肿性疾病。累及颌骨的儿童放线菌病较为罕见。迄今为止,分别有20例和1例累及下颌骨和上颌骨的病例报道。一名4岁女童两个月前因右侧上颌骨后部出现广泛的有症状溃疡性病变且伴有骨暴露而前来就诊。一个月前,她被诊断出患有猩红热。病变进展,破坏了支持性牙周组织。手术切除坏死骨和乳牙后,显微镜检查显示为放线菌病,经过氧化氢溶液局部治疗和良好的口腔卫生措施后,愈合良好。尽管累及儿童患者的颌骨放线菌病罕见,但儿童牙医必须了解其临床病理特征,这对治疗和预后有重要影响。

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