Postextraction osteomyelitis in a bone marrow transplant recipient

Andrei Barasch, Kristine Mosier, Joseph A. D'Ambrosio, Martin S. Giniger, Joao Ascensao, Douglas E. Peterson

Research output: Contribution to journalArticle

10 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)391-396
Number of pages6
JournalOral Surgery, Oral Medicine, Oral Pathology
Volume75
Issue number3
DOIs
StatePublished - 1993
Externally publishedYes

Fingerprint

Osteomyelitis
Bone Marrow Transplantation
Bone Marrow
Tooth Extraction
Indwelling Catheters
Staphylococcus epidermidis
National Cancer Institute (U.S.)
Bacteremia
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Fever
Guidelines
Anti-Bacterial Agents
Transplant Recipients
Infection
Therapeutics

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dentistry(all)

Cite this

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 journalArticle

Barasch, Andrei ; Mosier, Kristine ; D'Ambrosio, Joseph A. ; Giniger, Martin S. ; Ascensao, Joao ; Peterson, Douglas E. / Postextraction osteomyelitis in a bone marrow transplant recipient. In: Oral Surgery, Oral Medicine, Oral Pathology. 1993 ; Vol. 75, No. 3. pp. 391-396.
@article{4c519be2c7174d769a4e5874acc40c79,
title = "Postextraction osteomyelitis in a bone marrow transplant recipient",
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.",
author = "Andrei Barasch and Kristine Mosier and D'Ambrosio, {Joseph A.} and Giniger, {Martin S.} and Joao Ascensao and Peterson, {Douglas E.}",
year = "1993",
doi = "10.1016/0030-4220(93)90157-Y",
language = "English (US)",
volume = "75",
pages = "391--396",
journal = "Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology",
issn = "2212-4403",
publisher = "Elsevier USA",
number = "3",

}

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 -