婴幼儿急性上颌骨骨髓炎合并鼻中隔脓肿1例并文献复习

doi:10.6040/j.issn.1673-3770.0.2021.402

Abstract

Abstract: Objective To investigate the clinical manifestations, diagnostic reasoning, treatment, and prognosis of infant maxillary osteomyelitis complicated with nasal septal abscess. Methods The clinical data of one child with acute maxillary osteomyelitis complicated with septal abscess were retrospectively analyzed. Relevant studies from the literature published in China and overseas from 1956 to 2021 were retrieved and analyzed. In total, the published studies reported on 84 patients. The clinical manifestations, treatment methods, and prognosis, were summarized. Results Of the 84 patients with acute maxillary osteomyelitis, 53 were male, 29 were female, and the sex of 2 was unknown. The key presenting symptoms included nasal obstruction, facial swelling, and fever. The diagnosis was confirmed based on the imaging features of maxillary bone destruction, bone hyperplasia, and sclerosis, as well as the clinical manifestations of the children. Staphylococcus aureus was the most common pathogen identified. Staphylococcus epidermidis, Streptococcus, and Acinetobacter calcoaceticus were also detected. Maxillary osteomyelitis frequently co-occurs with orbital abscess or maxillary alveolar abscess. However, maxillary osteomyelitis with septal abscess in children is rare. In the literature, only one 14-year-old patient with maxillary osteomyelitis complicated with nasal septal abscess and previous relevant dental history has been reported. Treatment with intravenous broad-spectrum antibiotics and incisional drainage of the localized abscess can lead to a positive therapeutic outcome. Conclusion Staphylococcus aureus is the main pathogen associated with acute maxillary osteomyelitis in infants. Early administration of antibiotics to control the infection is recommended. For localized abscesses in the eyes, oral cavity, maxillary alveolar cavity, or nasal cavity, timely detection and early incisional drainage should be performed to minimize the destruction caused by inflammation and infection, leading to necrosis of the maxillary bone, arrested tooth development, or nasal septum cartilage necrosis leading to external nasal collapse.

Key words: Infants, Maxillary osteomyelitis, Nasal septal abscess, Bacterial culture

CLC Number:

R765.3

WANG Juan, SONG Yingluan, GENG Jiangqiao, WEN Xin, SHI Yanan. Acute maxillary osteomyelitis complicated with nasal septal abscess in an infant: a case report and literature review[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 91-96.

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Acute maxillary osteomyelitis complicated with nasal septal abscess in an infant: a case report and literature review

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