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Tiwari AV, Dangore-Khasbage S. Management of a Partially Treated Case of Chronic Osteomyelitis of the Hard Palate and Maxillary Sinus. Cureus 2024; 16:e58983. [PMID: 38800228 PMCID: PMC11127707 DOI: 10.7759/cureus.58983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
Osteomyelitis affects bones, including both cortex and medulla. It influences the mandible more frequently than the maxilla. Probable etiologic factors include foci of infection or trauma; however, the hematogenous spread of infection from a distant site is also a causative factor. Staphylococcus is the common organism involved in the causation. Clinical symptoms include signs of inflammation, pus drainage, fistulous or sinus tracts, wound disintegration, erythema, and raised local temperatures. Laboratory diagnosis with the evaluation of white blood cell count, rate of erythrocyte sedimentation, and C-reactive protein proves vitally significant. Radiographic evaluation reveals sequestra and bone destruction in the affected region. Histopathology of the lesion is confirmatory for the final diagnosis, which helps in the formulation of an appropriate management strategy. The treatment regimen usually focuses on thorough debridement of the necrotic material and an antibiotic regimen. This case report describes a male patient aged 45 years presenting with a palatal ulcer, severe halitosis, and speech difficulty. He has suffered from type II diabetes mellitus for four years. A radiological examination was carried out. Treatment was performed with surgical debridement of necrotic maxillary bone and curettage of bilateral maxillary and ethmoid sinuses under general anesthesia. Results of histopathological evaluation of the curetted material from the maxillary and ethmoid sinuses revealed osteomyelitis of the maxilla.
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Affiliation(s)
- Aakanksha V Tiwari
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Suwarna Dangore-Khasbage
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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El Fadhlallah PM, Nugraha AP, Prasetio O, Mulyawan I. Extensive Sequestration Chronic Maxillary Osteomyelitis in an Uncontrolled Diabetic Patient: Comprehensive Case Management of a Rare Entity. Eur J Dent 2024; 18:401-407. [PMID: 37848069 PMCID: PMC10959603 DOI: 10.1055/s-0043-1771536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
The hallmark of osteomyelitis was progressive bone destruction and sequestrum formation. In the underlying disease, like diabetes mellitus, osteomyelitis becomes severe and exacerbates the condition. It was essential for the oral and maxillofacial surgeon to comprehend its complex medical and surgical management to achieve complete disease eradication. The aim of this article was to report a rare case and comprehensive management of extensive sequestrating maxillary osteomyelitis with uncontrolled diabetes mellitus patients. A 58-year-old male patient with pain and swelling accompanied by discharge of pus in the sinistra maxilla region. The systemic disease was identified as uncontrolled diabetes mellitus, and had a history of unhealing wounds 1 year ago after upper left molar extraction. Computed tomography scan result showed extensive sequester formation and bony destruction in the right extending to the left maxilla. Microbial culture results were Klebsiella pneumoniae and Morganella morganii. Subsequently, extensive sequestrectomy and multiple extractions of the involved jaw and teeth were performed after diabetes mellitus was regulated. A suspension suture against oral and nasal mucosa was performed to avoid dead space formation. Comprehensive perioperative management in maxillary osteomyelitis in uncontrolled diabetes mellitus includes sequestrectomy, definitive antibiotic therapy based on culture results, and diabetes regulation to improve the successful management of this case.
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Affiliation(s)
| | - Andreas Pratama Nugraha
- Oral and Maxillofacial Surgery Specialist Program, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| | - Okky Prasetio
- Department of Oral and Maxillofacial Surgery, Dr Mohamad Soewandhie General Hospital, Surabaya, Indonesia
| | - Indra Mulyawan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine Universitas Airlangga, Surabaya, Indonesia
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Kulkarni P, Beeraka D, Tanwar M, Kim U, Ganesan RM, Saini P. Frontal osteomyelitis post-COVID-19 associated mucormycosis. Indian J Ophthalmol 2023; 71:2906-2910. [PMID: 37417145 PMCID: PMC10491079 DOI: 10.4103/ijo.ijo_3117_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/11/2023] [Accepted: 05/25/2023] [Indexed: 07/08/2023] Open
Abstract
Rhino-orbito-cerebral mucormycosis (ROCM) is the most commonly noted form of mucormycosis, which is the most common secondary fungal infection following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Osteomyelitis is one of the rare sequelae of ROCM, frontal osteomyelitis being the rarest. We present four patients of coronavirus disease 2019 (COVID-19)-associated mucormycosis, who presented with frontal bone osteomyelitis after being treated for ROCM surgically and medically. This is the first case series highlighting this complication in post-COVID-19 mucormycosis patients and needs utmost attention as it can be life-threatening and can cause extreme facial disfiguration. All four patients are alive with salvage of the affected globe and vision being preserved in one patient. If identified early, disfiguration of face and intracranial extension can be avoided.
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Affiliation(s)
- Pooja Kulkarni
- Department of Orbit, Oculoplasty, Ocular Oncology and Ocular Prosthesis, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Deepika Beeraka
- Ophthalmology Resident, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Meghana Tanwar
- Department of Orbit, Oculoplasty, Ocular Oncology and Ocular Prosthesis, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Usha Kim
- Department of Orbit, Oculoplasty, Ocular Oncology and Ocular Prosthesis, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | | | - Pragya Saini
- Department of Orbit, Oculoplasty, Ocular Oncology and Ocular Prosthesis, Aravind Eye Hospital, Madurai, Tamil Nadu, India
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Chugh A, Punia P, Gotecha S, Rege I, Shinde V. Post Mucormycosis Frontal Bone Osteonecrosis: "A Road Less Traveled During the Pandemic". World Neurosurg 2023; 172:e335-e342. [PMID: 36639099 DOI: 10.1016/j.wneu.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND Osteonecrosis in mucormycosis is a rare phenomenon and has been reported usually following trauma or in immunocompromised individuals. Osteonecrosis of skull as a complication of mucormycosis is a rare presentation, which makes the study ever so rare and interesting. METHODS Within 6 months, a total of 114 patients presented with mucormycosis as COVID-19 sequel, 60 of whom underwent form of endoscopic sinus debridement. Six of these 60 patients presented with frontal bone osteonecrosis and were included in the study. All 6 patients presented within a time period of 2-4 months' post FESS. RESULTS One of the 6 patients succumbed to her illness. Another patient presented with local recurrence after 3 months, for which she underwent resurgery and debridement. The other 4 patients showed gradual recovery and are without symptoms or radiologic progression at 6-month follow-up. CONCLUSIONS Osteonecrosis in mucormycosis is a rare phenomenon, and the 2 entities have rarely been reported together. The disease usually limits itself to the frontal bone only, and pathogenesis for spread is due to a vicious cycle of infection and ischemia. Prompt diagnosis via imaging, aggressive surgical debridement with a good antifungal cover, good patient compliance, and regular follow-up form the mainstay of treatment.
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Affiliation(s)
- Ashish Chugh
- Department of Neurosurgery, Dr D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
| | - Prashant Punia
- Department of Neurosurgery, Dr D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
| | - Sarang Gotecha
- Department of Neurosurgery, Dr D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
| | - Ishant Rege
- Department of Neurosurgery, Dr D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India.
| | - Vinod Shinde
- Department of Ear, Nose, and Throat, Dr D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune
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Kaple GS, Patil S, Mundada PH, Kaple NA. Physiotherapy Management for Surgical Defect of Operated Mucormycotic Osteomyelitis of Maxilla: Post COVID-19. Cureus 2023; 15:e34733. [PMID: 36909036 PMCID: PMC9997684 DOI: 10.7759/cureus.34733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/31/2023] [Indexed: 02/10/2023] Open
Abstract
The maxilla is among the jaw bones with a lot of blood flow. Maxillary bone necrosis is uncommon and can be caused by infection, trauma, or unusual metabolic abnormalities. The maxilla is a vital bone that forms the roof of the mouth cavity. Mucormycosis is a prevalent fungus that infects the maxilla, particularly in diabetic and immune-compromised people and post-COVID-19 patients. Osteomyelitis is an inflammatory condition affecting the bone and marrow tissues. It is an opportunistic infection that occurs due to the host's susceptibility to illness due to the complication of other diseases. The patient, in this case, has the chief complaint of a defect in the palate. Based on a CT brain, buccal X-Ray, and HRCT scan of Thorax. The patient's condition was diagnosed as a surgical defect in a post-operated case of mucormycotic osteomyelitis of maxilla post-COVID-19 infection. The right lower lobe's posterior segment noted a tiny soft tissue density nodule. The operated case of a surgical defect of mucormycotic osteomyelitis of maxilla post-COVID-19 infection was treated with a surgical intervention that is surgical curettage and debridement of the left maxillary sinus, bilateral fibrotomy, and reconstruction with bilateral nasolabial flap under general anesthesia. However, our objective is to enhance the quality of life, increase ventilation, increase the shoulder joint's range of motion, and enhance the joint play of the temporomandibular joint so that the patient can go back to his usual activities without difficulty. A complete pulmonary rehabilitation plan was designed to meet the patient's objectives, executed, and followed for one month. It comprised myriad interventions like bedside sitting, facial expression exercises, mouth opening exercises, neck exercises, dynamic quadriceps and hamstring, active range of motion exercises for shoulder joints, thoracic expansion exercises, and breathing exercises like diaphragmatic breathing.
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Affiliation(s)
- Gayatri S Kaple
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Shubhangi Patil
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Purva H Mundada
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Nikita A Kaple
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Kang YH, Lee SS, Aung MTZ, Kang JH, Kim JE, Huh KH, Heo MS. Mucormycosis-related osteomyelitis of the maxilla in a post-COVID-19 patient. Imaging Sci Dent 2022; 52:435-440. [PMID: 36605866 PMCID: PMC9807792 DOI: 10.5624/isd.20220143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 12/28/2022] Open
Abstract
Mucormycosis is a rare, invasive fungal infection that progresses aggressively and requires prompt surgery and appropriate treatment. The number of cases of mucormycosis in coronavirus disease 2019 (COVID-19) patients has recently increased, and patients with uncontrolled diabetes mellitus are particularly at an elevated risk of infection. This report presents a case of mucormycosis-related osteomyelitis of the maxilla in a 37-year-old man with diabetes mellitus. The patient complained of severe and persistent pain in the right maxilla, accompanied by increased tooth mobility and headache. On contrast-enhanced computed tomographic images, gas-forming osteomyelitis of the right maxilla was observed. Destruction of the maxilla and palatine bone then proceeded aggressively. Sequestrectomy was performed on the right maxilla, and the histopathological diagnosis was mucormycosis. Further investigation after the first operation revealed the patient's history of COVID-19 infection.
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Affiliation(s)
- Yun-Hui Kang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Moe Thu Zar Aung
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea.,Department of Oral Medicine, University of Dental Medicine, Mandalay, Myanmar
| | - Ju-Hee Kang
- Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea
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Arshad W, Mahmood Kamal M, Rafique Z, Rahat M, Mumtaz H. Case of maxillary actinomycotic osteomyelitis, a rare post COVID complication-case report. Ann Med Surg (Lond) 2022; 80:104242. [PMID: 35936558 PMCID: PMC9339092 DOI: 10.1016/j.amsu.2022.104242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction and Importance: Maxillary actinomycosis is a persistent, very rare disease produced by Actinomyces species which may include only soft tissue or bone or the two together. Actinomycotic osteomyelitis of maxilla is very infrequent when compared to mandible. Case presentation Here we are conferring a case of an elderly male patient who had history of COVID-19 infection 4 months ago, with constant complaint of non-remitting vague pain in the region of maxilla with tooth loosening and extractions. He was given a provisional diagnosis of chronic osteomyelitis of maxilla which was later on proved by histopathology as actinomycotic osteomyelitis. Clinical discussion A saprophytic fungus causes mucor mycosis, and it is quite unusual. Strawberry gingivitis is one of the signs and symptoms. Mucormycosis and post-covid oral maxillofacial problems can be improved with early diagnosis. Oral Mucormycosis should be suspected in individuals with weakened immune systems, uncontrolled diabetes or post-covid instances. Surgery and adequate antibiotic treatment are necessary to treat actinomycosis. Infection may return after a period of inactivity, so long-term follow-up is necessary. Conclusion We conclude a positive causal association between COVID-19 and actinomycosis. Maxillary osteomyelitis, a very rare infection, and in our case, the causative organism was Actinomyces Patients who have been infected should be tested for Actinomycin, which may masquerade as a head and neck illness. Osteomyelitis caused by fungus is a potentially fatal opportunistic illness that is extremely rare. The orofacial region is usually affected, particularly the nose and paranasal sinuses. It's a dangerous infection that must be treated right away if it isn't to become fatal. Thrombosis and necrosis of adjacent hard and soft tissues occur as a result of vascular tissue invasion upon inhalation of the pathogen. Infection begins in the nose and paranasal sinuses and progresses to the lungs. We Present an old male patient with history of COVID-19 infection with chronic non-remitting nonspecific discomfort in the region of maxilla with teeth loosening and extractions. Histopathology later revealed that he had actinomycotic osteomyelitis, which was initially diagnosed as chronic maxillary osteomyelitis.
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Affiliation(s)
- Wajiha Arshad
- Consultant Radiologist, KRL Hospital Islamabad, Pakistan
| | | | | | - Manahil Rahat
- Resident Oral Pathology, Armed Forces Institute of Pathology, Pakistan
| | - Hassan Mumtaz
- Clinical Research Associate, Maroof International Hospital Islamabad, Public Health Scholar, Health Services Academy Islamabad, Pakistan
- Corresponding author.
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Maxillary Fungal Osteomyelitis Mimicking and Treated as Endodontic Pathosis. Case Rep Dent 2022; 2022:1976352. [PMID: 35846181 PMCID: PMC9287005 DOI: 10.1155/2022/1976352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/01/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
Fungal osteomyelitis is a lethal opportunistic infection that affects only a small percentage of patients present to endodontists. It is a highly contagious infection that requires urgent treatment. We discuss three cases in which endodontic pathology was initially recognized but subsequent follow-up revealed severe osteolytic fungal infection of the maxilla manifesting as acute apical abscesses in the maxillary canine region. CBCT demonstrated osteolytic abnormalities, and further histology confirmed the illness was caused by mucormycosis in patients with uncontrolled diabetes mellitus and exposure to COVID-19.
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Band SS, Ardabili S, Yarahmadi A, Pahlevanzadeh B, Kiani AK, Beheshti A, Alinejad-Rokny H, Dehzangi I, Chang A, Mosavi A, Moslehpour M. A Survey on Machine Learning and Internet of Medical Things-Based Approaches for Handling COVID-19: Meta-Analysis. Front Public Health 2022; 10:869238. [PMID: 35812486 PMCID: PMC9260273 DOI: 10.3389/fpubh.2022.869238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Early diagnosis, prioritization, screening, clustering, and tracking of patients with COVID-19, and production of drugs and vaccines are some of the applications that have made it necessary to use a new style of technology to involve, manage, and deal with this epidemic. Strategies backed by artificial intelligence (A.I.) and the Internet of Things (IoT) have been undeniably effective to understand how the virus works and prevent it from spreading. Accordingly, the main aim of this survey is to critically review the ML, IoT, and the integration of IoT and ML-based techniques in the applications related to COVID-19, from the diagnosis of the disease to the prediction of its outbreak. According to the main findings, IoT provided a prompt and efficient approach to tracking the disease spread. On the other hand, most of the studies developed by ML-based techniques aimed at the detection and handling of challenges associated with the COVID-19 pandemic. Among different approaches, Convolutional Neural Network (CNN), Support Vector Machine, Genetic CNN, and pre-trained CNN, followed by ResNet have demonstrated the best performances compared to other methods.
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Affiliation(s)
- Shahab S. Band
- Future Technology Research Center, College of Future, National Yunlin University of Science and Technology, Douliou, Taiwan
| | - Sina Ardabili
- Department of Informatics, J. Selye University, Komárom, Slovakia
| | - Atefeh Yarahmadi
- Future Technology Research Center, College of Future, National Yunlin University of Science and Technology, Douliou, Taiwan
| | - Bahareh Pahlevanzadeh
- Department of Design and System Operations, Regional Information Center for Science and Technology (R.I.C.E.S.T.), Shiraz, Iran
| | - Adiqa Kausar Kiani
- Future Technology Research Center, College of Future, National Yunlin University of Science and Technology, Douliou, Taiwan
| | - Amin Beheshti
- Department of Computing, Macquarie University, Sydney, NSW, Australia
| | - Hamid Alinejad-Rokny
- BioMedical Machine Learning Lab, The Graduate School of Biomedical Engineering, U.N.S.W. Sydney, Sydney, NSW, Australia
- U.N.S.W. Data Science Hub, The University of New South Wales (U.N.S.W. Sydney), Sydney, NSW, Australia
- Health Data Analytics Program, AI-enabled Processes (A.I.P.) Research Centre, Macquarie University, Sydney, NSW, Australia
| | - Iman Dehzangi
- Department of Computer Science, Rutgers University, Camden, NJ, United States
- Center for Computational and Integrative Biology, Rutgers University, Camden, NJ, United States
| | - Arthur Chang
- Bachelor Program in Interdisciplinary Studies, National Yunlin University of Science and Technology, Douliu, Taiwan
| | - Amir Mosavi
- John von Neumann Faculty of Informatics, Obuda University, Budapest, Hungary
- Institute of Information Engineering, Automation and Mathematics, Slovak University of Technology in Bratislava, Bratislava, Slovakia
| | - Massoud Moslehpour
- Department of Business Administration, College of Management, Asia University, Taichung, Taiwan
- Department of Management, California State University, San Bernardino, CA, United States
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