小児の下顎枝部に生じた放線菌性下顎骨骨髄炎の1例

• Published in: 日本口腔外科学会雑誌 Vol. 64; no. 3; pp. 159 - 164
• Main Authors: 平井, 雄三, 山本, 信祐, 上原, 京憲, 谷池, 直樹, 宇佐美, 悠, 竹信, 俊彦
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.03.2018
• Subjects: 下顎枝; 小児; 放線菌症; 骨髄炎
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.64.159

Osteomyelitis of the mandible commonly occurs in the mandibular body and is rarely seen in the mandibular condyle. We report a case of actinomycotic osteomyelitis extending from the mandibular ramus to the condyle in a child. A 15-year-old girl was referred to our hospital because of swelling and pain in the left buccal region. Computed tomography (CT) revealed bone resorption and periosteal reaction from the left temporomandibular joint region to the mandibular notch and coronoid process. Based on the CT and magnetic resonance imaging findings, we suspected actinomycotic osteomyelitis of the mandible and then administered penicillin. An abscess was detected in the left parotid masseter region after starting penicillin administration, and necrotic tissue debridement was performed. A group of actinomycetes was identified in the sampled specimen. New bone formation was observed on post-treatment CT, and 99m Tc bone scintigraphy uptake was reduced. Antibiotic treatment was therefore discontinued after approximately 5 months. The patient is currently recovering well without any signs or symptoms of recurrence