J Dent Anesth Pain Med.  2020 Aug;20(4):251-259. 10.17245/jdapm.2020.20.4.251.

Treatment of life-threatening acute osteomyelitis of the jaw during chemotherapy: a case report

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
  • 2Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Seoul National University, Seoul, Korea

Abstract

Oral and maxillofacial infection is a common complication in patients undergoing chemotherapy. The treatment of oral diseases in such patients differs from that administered to healthy patients. This paper reports a case of acute osteomyelitis of odontogenic origin following a recent chemotherapy session. The patient’s condition was life-threatening because of neutropenic fever and sepsis that developed during the inpatient supportive care. However, the patient showed prompt recovery within 40 days following the use of appropriate antibiotics and routine dressing, without the requirement for surgical treatment, except tooth extraction. As seen in this case, patients undergoing chemotherapy are more susceptible to rapid progression of infections in the oral and maxillofacial areas. Therefore, accurate diagnosis through prompt clinical and radiological examination, identification of the extent of infection, and assessment of the patient’s immune system are crucial for favorable outcomes. It is also necessary to eliminate the source of infection through appropriate administration of antibiotics. In particular, a broad-spectrum antibiotic with anti-pneumococcal activity is essential. Proper antibiotic administration and wound dressing are essential for infection control. Furthermore, close consultation with a hemato-oncologist is necessary for effective infection management based on the professional evaluation of patients’ immune mechanisms.

Keyword

Acute Osteomyelitis; Chemotherapy; Maxillofacial Abscess; Neutropenia; Oral Infection
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