Vol.68 No.6 November 2020
A case of antiresorptive agent-related osteonecrosis of the jaw complicated by necrotizing soft-tissue infection
1)Department of Oral and Maxillofacial Surgery, University of the Ryukyus Hospital, Uehara 207, Nishihara, Nakagami, Okinawa, Japan
2)Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus
3)Department of Infection control room, University of the Ryukyus Hospital
Abstract
A 75-year-old woman visited our hospital with the complaint of swelling over the left buccal region. She had a medical history of diabetes mellitus, hypertension and osteoporosis, and was under numerous medications, including a bisphosphonate for osteoporosis. Hematological examination revealed elevation of inflammatory markers, and CT revealed cellulitis of the subcutaneous tissue over the left temporal region and multiple abscesses with gas shadows in the masticator space. Based on the judgment that she needed to be hospitalized for adequate management, the patient was admitted our hospital and started on antibiotic therapy. Surgical incision and drainage was performed four times under local anesthesia. After the antibiotic therapy, necrotomy and sequestrectomy were performed under general anesthesia. Herein, we report our experience with a patient with antiresorptive agent-related osteonecrosis of the jaw complicated by necrotizing soft-tissue infection, along with some review of the literature.
Key word
necrotizing soft-tissue infection, temporal fossa, gas gangrene, necrotizing fasciitis, bisphosphonate-associated osteonecrosis of the jaw
Received
November 18, 2019
Accepted
September 3, 2020
Jpn. J. Chemother. 68 (6): 619-626, 2020
