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下颌骨曲霉性骨髓炎:一例报告及文献综述

Aspergillosis Osteomyelitis of the Mandible: A Case Report and Literature Review.

作者信息

Attouchi Ikram, Bouslama Ghada, Ben Messaoud Nour Sayda, Amira Atig, Kmira Zahra, Yosra Ben Youssef, Oualha Lamia, Sriha Badreddine, Ben Youssef Souha

机构信息

Dental Medicine, Farhat Hached University Hospital, Sousse, Tunisia.

Internal Medicine, Farhat Hached University Hospital, Sousse, Tunisia.

出版信息

Sage Open Pathol. 2025 May 29;18:30502098251344770. doi: 10.1177/30502098251344770. eCollection 2025 Jan-Dec.

Abstract

Aspergillosis is an uncommon fungal infection caused by Aspergillus species, predominantly affecting immunocompromised individuals. While pulmonary involvement is common, extrapulmonary manifestations such as osteomyelitis are uncommon. Aspergillus osteomyelitis of the mandible is an exceptionally rare and life-threatening condition, posing significant diagnostic and therapeutic challenges. We present the case of a 13-year-old immunocompromised patient diagnosed with this condition. The patient presented with persistent jaw pain, swelling, and radiographic evidence of extensive bone destruction. Diagnosis was confirmed through fungal cultures and histopathological examination, which identified Aspergillus species. The patient underwent surgical debridement and prolonged antifungal therapy, leading to clinical improvement. Aspergillus osteomyelitis of the mandible is exceedingly rare, with only a few cases reported in the literature. Early diagnosis is crucial to prevent further bone destruction and associated complications. This case underscores the importance of considering fungal infections in the differential diagnosis of osteomyelitis, particularly in at-risk populations. It also emphasizes the potential role of antifungal prophylaxis in reducing the severity of invasive fungal infections when they occur. Managing this condition presents significant challenges, including the need for aggressive antifungal therapy and the risk of recurrence.

摘要

曲霉病是一种由曲霉菌种引起的罕见真菌感染,主要影响免疫功能低下的个体。虽然肺部受累很常见,但骨髓炎等肺外表现并不常见。下颌骨曲霉性骨髓炎是一种极其罕见且危及生命的疾病,带来了重大的诊断和治疗挑战。我们报告一例13岁免疫功能低下患者被诊断为此病的病例。该患者表现为持续性颌骨疼痛、肿胀以及广泛骨质破坏的影像学证据。通过真菌培养和组织病理学检查确诊,确定为曲霉菌种。患者接受了手术清创和长期抗真菌治疗,病情得到临床改善。下颌骨曲霉性骨髓炎极为罕见,文献中仅报道了少数病例。早期诊断对于防止进一步的骨质破坏和相关并发症至关重要。该病例强调了在骨髓炎鉴别诊断中考虑真菌感染的重要性,特别是在高危人群中。它还强调了抗真菌预防在降低侵袭性真菌感染发生时严重程度方面的潜在作用。处理这种疾病面临重大挑战,包括需要积极的抗真菌治疗以及复发风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2615/12161888/2552eb0e222b/10.1177_30502098251344770-fig1.jpg

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