Temporal cellulitis of odontogenic origin complicated by temporomandibular osteoarthritis

Temporal cellulitis of odontogenic origin complicated by temporomandibular osteoarthritis

Rev Stomatol Chir Maxillofac. 2008 Apr

Persac S, Péron JM.
Service de chirurgie maxillofaciale et stomatologie, centre hospitalier universitaire Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.

INTRODUCTION: Temporal cellulitis complicated by temporomandibular osteoarthritis and mandibular osteomyelitis is rare with the availability of antibiotics and the prevention of dental infections.

CASE REPORT: A 56 year-old woman developed a jaw abscess during hospitalization in an intensive care unit following medical drug overdose. Repeatedly surgical drainage was performed guided by CT scans and multiple antibiotherapies. CT scan follow-up revealed temporomandibular arthritis with decrease of the joint space, synovitis, and subchondral cysts. Slow improvement was noted but limited mouth opening was persistent.

DISCUSSION: This case illustrates the insidious evolution of an uncommon infection. It requires both expert clinical evaluation and an early MRI or CT scan investigation to determine the extension of the infection. Treatment is urgent because of the prognosis and is achieved by surgical drainage and adequate long-term antibiotherapy.

Masson.fr

Natural Killer/T-cell Lymphoma Masquerading as Orbital Cellulitis.

Natural Killer/T-cell Lymphoma Masquerading as Orbital Cellulitis.

Mar 2008 Ophthal Plast Reconstr Surg.

Charton J, Witherspoon SR, Itani K, Jones FR, Marple B, Morse B.
Departments of *Ophthalmology, †Otolaryngology, Head and Neck Surgery, and ‡Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.

We describe 3 cases of natural killer/T-cell lymphoma that presented by masquerading as orbital cellulitis. All of the patients were examined for pain, fever, proptosis, and motility restriction. Computed tomography of the orbits and sinuses revealed orbital soft-tissue swelling without focal abscess in all 3 cases. Bacterial and fungal cultures were negative in each case and all of the patients had initial improvement on systemic antibiotics, only to relapse several days later. Diagnosis of natural killer/T-cell lymphoma was then made based on biopsy of the orbit or sinus. Natural killer/T-cell lymphoma should be considered in cases of orbital cellulitis or sinusitis that fail to respond to traditional management. Biopsy of the affected region should be performed expeditiously to diagnose this condition. Repeat biopsy may be needed.

Lippincott, Wilkins & Williams

Orbital cellulitis or lymphoma? A diagnostic challenge.

J Laryngol Otol. 2005 Sep

Salam A, Saldana M, Zaman N.
Southampton Eye Unit, Southampton General Hospital, UK. aysha_salam@yahoo.com

We present a case report of an aggressive natural killer T cell lymphoma in a police officer who presented with combined features of orbital cellulitis and mid-facial destruction. However, his initial diagnosis was confused with other disease conditions that had overlapping features. This emphasizes the significance of clinical alertness and adequate tissue sampling; this can have a great impact on early diagnosis and treatment.

PMID: 16156921 [PubMed - indexed for MEDLINE]