Recurrent Chronic Maxillary Osteomyelitis in a Child: A Rare Presentation

Abstract

Objective Osteomyelitis in the craniofacial region could result from untreated dental conditions such as pulpal or periodontal infections or by direct inoculation from trauma or surgery. Its development is influenced by a decreased host defensive mechanism and could result in major complications such as infection of the brain and cranium, making prompt and correct diagnosis of maxillary osteomyelitis crucial in its management. The objective of this study was to report a rare case of recurrent maxillary chronic osteomyelitis in an 11-year-old.

Case report: An 11-year-old boy who presented to the Paediatric Dental Clinic of the University of Benin Teaching Hospital with left sided facial swelling, purulent discharge from his left eye and left preauricular region of one-week duration. Past history revealed patient had being managed with similar symptoms at age 6 and had a partial maxillectomy done 5 years prior. Following clinical examination, radiological assessment (CT scan) and laboratory investigation (culture yielded growth of Staphylococcus arlettae) a diagnosis of recurrent chronic suppurating osteomyelitis was made. Patient was severely anaemic with underlying malnutrition and had to be optimized for surgery which was surgical debridement and drainage of abscess under general anaesthesia and patient placed on antibiotics and patient responded well to treatment.   

Conclusion: Increased suspicion of rare disease conditions such as maxillary chronic osteomyelitis in children is important and more so a recurrent case as this. Management should be multidisciplinary and follow a holistic approach.