METHODS: This is the case of a 61-year-old female with breast cancer and on chemotherapy as well as non-invasive carcinoma of the tongue who initially presented to the dentist with white spots in the right mandible near the incisors associated with right mandible pain and swelling. Actinomyces-induced osteomyelitis of the mandible was diagnosed. The patient was treated with penicillin V for 6 weeks along with a course of hyperbaric oxygen therapy, which resulted in the complete resolution of the infection.
CONCLUSIONS: In summary, jaw osteomyelitis caused by Actinomyces should always be part of the differential diagnosis; as these organisms are commensal flora. The symptoms manifested are non-specific, and such a diagnosis could be easily missed, resulting in delay of care and disease progression.
方法:这是一名61岁女性患者,患有乳腺癌和化疗以及舌癌的非浸润性,最初向牙医就诊时,右下颌骨切牙附近有白斑,伴有右下颌骨疼痛和肿胀。诊断为放线菌引起的下颌骨骨髓炎。患者接受了青霉素V治疗6周,并进行了一个疗程的高压氧治疗,这导致了感染的完全解决。
结论:总之,由放线菌引起的颌骨骨髓炎应始终是鉴别诊断的一部分;因为这些生物是共生菌群,表现的症状是非特异性的,这样的诊断很容易被错过,导致护理延迟和疾病进展。