Edelstein H, Chirurgi V A, Hybarger C P
Kaiser Permanente Medical Center, San Rafael, Calif. 94903.
South Med J. 1993 Nov;86(11):1215-8. doi: 10.1097/00007611-199311000-00005.
Eight patients with osteomyelitis of the jaw were identified at two county hospitals over a 4-year period. Three patients (37.5%) were found to be HIV-seropositive, including two patients not previously known to be HIV-seropositive. Signs and symptoms of infection were similar in both groups of patients, and commonly included fever, pain, and swelling. Radiographs showed specific findings of osteomyelitis in one of three HIV-seropositive patients and four of four seronegative patients with chronic jaw infection. HIV-seropositive patients appeared to have a worse clinical outcome than their seronegative counterparts. We conclude that osteomyelitis of the jaw may be the presenting manifestation of HIV infection, and that careful attention and close follow-up should be applied to such patients because of their poor overall clinical response.
在4年期间，两家县级医院共确诊8例颌骨骨髓炎患者。其中3例（37.5%）HIV血清学检测呈阳性，包括2例此前未知HIV血清学阳性的患者。两组患者的感染体征和症状相似，常见的有发热、疼痛和肿胀。X线片显示，3例HIV血清学阳性患者中有1例、4例血清学阴性的慢性颌骨感染患者中有4例有骨髓炎的特异性表现。HIV血清学阳性患者的临床结局似乎比血清学阴性患者更差。我们得出结论，颌骨骨髓炎可能是HIV感染的首发表现，鉴于此类患者总体临床反应较差，应对其予以密切关注和随访。
