Abstract
This report describes a case of mandibular osteomyelitis after a dental extraction in a patient who subsequently underwent bone marrow transplantation (BMT) for lymphoblastic lymphoma. Surgical guidelines consistent with National Cancer Institute recommendations were followed for the extraction, which was performed before initiation of the myelosuppressive conditioning regimen. However, moderate tenderness developed at the extraction site beginning 10 days after marrow infusion. On day 26 the patient became febrile and blood culture-positive for Staphylococcus epidermidis. Radiographs exposed on day 28 demonstrated changes consistent with low-grade osteomyelitis, including diffuse loss of lamina dura and an irregular osseous rarefaction extending 1 cm posterior to the extraction site. Although the indwelling Hickman catheter was the presumed source for bacteremia, clinical and radiographic data led to consideration of mandibular osteomyelitis as an alternative cause. Characteristics of this infection in BMT recipients are reviewed. Recommendations for dental extractions and prophylactic antibiotic regimens for catheterized BMT recipients are also discussed. Although mandibular osteomyelitic lesions are not common in profoundly immunosuppressed BMT recipients, prompt recognition and treatment are essential when the disease occurs.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 391-396 |
| Number of pages | 6 |
| Journal | Oral Surgery, Oral Medicine, Oral Pathology |
| Volume | 75 |
| Issue number | 3 |
| DOIs | |
| State | Published - 1993 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Dentistry(all)
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Postextraction osteomyelitis in a bone marrow transplant recipient. / Barasch, Andrei; Mosier, Kristine; D'Ambrosio, Joseph A.; Giniger, Martin S.; Ascensao, Joao; Peterson, Douglas E.
In: Oral Surgery, Oral Medicine, Oral Pathology, Vol. 75, No. 3, 1993, p. 391-396.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Postextraction osteomyelitis in a bone marrow transplant recipient
AU - Barasch, Andrei
AU - Mosier, Kristine
AU - D'Ambrosio, Joseph A.
AU - Giniger, Martin S.
AU - Ascensao, Joao
AU - Peterson, Douglas E.
PY - 1993
Y1 - 1993
N2 - This report describes a case of mandibular osteomyelitis after a dental extraction in a patient who subsequently underwent bone marrow transplantation (BMT) for lymphoblastic lymphoma. Surgical guidelines consistent with National Cancer Institute recommendations were followed for the extraction, which was performed before initiation of the myelosuppressive conditioning regimen. However, moderate tenderness developed at the extraction site beginning 10 days after marrow infusion. On day 26 the patient became febrile and blood culture-positive for Staphylococcus epidermidis. Radiographs exposed on day 28 demonstrated changes consistent with low-grade osteomyelitis, including diffuse loss of lamina dura and an irregular osseous rarefaction extending 1 cm posterior to the extraction site. Although the indwelling Hickman catheter was the presumed source for bacteremia, clinical and radiographic data led to consideration of mandibular osteomyelitis as an alternative cause. Characteristics of this infection in BMT recipients are reviewed. Recommendations for dental extractions and prophylactic antibiotic regimens for catheterized BMT recipients are also discussed. Although mandibular osteomyelitic lesions are not common in profoundly immunosuppressed BMT recipients, prompt recognition and treatment are essential when the disease occurs.
AB - This report describes a case of mandibular osteomyelitis after a dental extraction in a patient who subsequently underwent bone marrow transplantation (BMT) for lymphoblastic lymphoma. Surgical guidelines consistent with National Cancer Institute recommendations were followed for the extraction, which was performed before initiation of the myelosuppressive conditioning regimen. However, moderate tenderness developed at the extraction site beginning 10 days after marrow infusion. On day 26 the patient became febrile and blood culture-positive for Staphylococcus epidermidis. Radiographs exposed on day 28 demonstrated changes consistent with low-grade osteomyelitis, including diffuse loss of lamina dura and an irregular osseous rarefaction extending 1 cm posterior to the extraction site. Although the indwelling Hickman catheter was the presumed source for bacteremia, clinical and radiographic data led to consideration of mandibular osteomyelitis as an alternative cause. Characteristics of this infection in BMT recipients are reviewed. Recommendations for dental extractions and prophylactic antibiotic regimens for catheterized BMT recipients are also discussed. Although mandibular osteomyelitic lesions are not common in profoundly immunosuppressed BMT recipients, prompt recognition and treatment are essential when the disease occurs.
UR - http://www.scopus.com/inward/record.url?scp=0027456646&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027456646&partnerID=8YFLogxK
U2 - 10.1016/0030-4220(93)90157-Y
DO - 10.1016/0030-4220(93)90157-Y
M3 - Article
C2 - 8469555
AN - SCOPUS:0027456646
VL - 75
SP - 391
EP - 396
JO - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
JF - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
SN - 2212-4403
IS - 3
ER -