Vargas-Rojas DC, Rodriguez-Flores A, Moreno-Villalobos D, Chumpitaz-Cerrate V, Chávez-Rimache L

Language: English
References: 24
Page: 14-20
PDF size: 418.81 Kb.

ABSTRACT

Diabetes mellitus is a systemic condition potentially related to an increased risk of progression of various infections such as chronic osteomyelitis by accelerating the inflammatory process with bone tissue necrosis and suppuration. Therefore, if there is no proper management of these infections, they can be life-threatening as they spread to deeper spaces in the head and neck. We describe the case of a 52-year-old male patient with a history of diabetes mellitus and grade III osteoarthritis who was diagnosed with chronic suppurative osteomyelitis of the mandible. He underwent a multidisciplinary surgical intervention in which he underwent a hemimandibulectomy with immediate mandibular reconstruction. The present case highlights the importance of early and radical treatment of patients with chronic suppurative osteomyelitis of the mandible and systemic comorbidities. In addition, this case presents a review of diabetes mellitus and the risk of developing odontogenic infections and complications when invading deeper spaces in the head and neck. Therefore, in this population, careful planning is required for early surgical and pharmacological treatment.

REFERENCES

1. Abu-Ashour W., Twells L., Valcour J., Randell A., Donnan J., Howse P., et al. The association between diabetes mellitus and incident infections: a systematic review and meta-analysis of observational studies. BMJ Open Diabetes Research and Care. 2017 May 1; 5 (1): e000336.

2. Ko H.H., Chien W.C., Lin Y.H., Chung C.H., Cheng S.J. Examining the correlation between diabetes and odontogenic infection: A nationwide, retrospective, matched-cohort study in Taiwan. PLoS One. 2017 Jun 8; 12 (6): e0178941. doi: 10.1371/journal.pone.0178941

3. Carr M.E. Diabetes mellitus: a hypercoagulable state. J Diabetes Complications. 2001 Jan-Feb; 15 (1): 44-54. doi: 10.1016/s1056-8727(00)00132-x

4. Ammar R.F. Jr., Gutterman D.D., Brooks L.A., Dellsperger K.C. Free radicals mediate endothelial dysfunction of coronary arterioles in diabetes. Cardiovasc Res. 2000 Aug 18; 47 (3): 595-601. doi: 10.1016/s0008-6363(00)00094-8

5. DiGangi C. Neutrophil-lymphocyte ratio: Predicting cardiovascular and renal complications in patients with diabetes. J Am Assoc Nurse Pract. 2016 Aug; 28 (8): 410-4. doi: 10.1002/2327-6924.12366

6. Valerius N.H., Eff C., Hansen N.E, Karle H., Nerup J., Sřeberg B., Sřrensen S.F. Neutrophil and lymphocyte function in patients with diabetes mellitus. Acta Med Scand. 1982; 211 (6): 463-7. doi: 10.1111/j.0954-6820.1982.tb01983.x

7. Delamaire M., Maugendre D., Moreno M., Le Goff M.C., Allannic H., Genetet B. Impaired leucocyte functions in diabetic patients. Diabet Med. 1997 Jan; 14 (1): 29-34. doi: 10.1002/(SICI)1096-9136(199701)

8. Huang T.T., Tseng F.Y., Liu T.C., Hsu C.J., Chen Y.S. Deep neck infection in diabetic patients: comparison of clinical picture and outcomes with nondiabetic patients. Otolaryngol Head Neck Surg. 2005 Jun; 132 (6): 943-7. doi: 10.1016/j.otohns.2005.01.035

9. Chen M.K., Wen Y.S., Chang C.C., Huang M.T., Hsiao H.C. Predisposing factors of life-threatening deep neck infection: logistic regression analysis of 214 cases. J Otolaryngol. 1998 Jun; 27 (3): 141-4.

10. Carey I.M., Critchley J.A., DeWilde S., Harris T., Hosking F.J., Cook D.G. Risk ofInfection in Type 1 and Type 2 Diabetes Compared With the General Population: A Matched Cohort Study. Diabetes care. 2018; 41 (3): 513-21. doi: 10.2337/dc17-2131

11. Fullmer J.M., Scarfe W.C., Kushner G.M., Alpert B., Farman A.G. Cone beam computed tomographic findings in refractory chronic suppurative osteomyelitis of the mandible. Br J Oral Maxillofac Surg. 2007 Jul; 45 (5): 364-71. doi: 10.1016/j.bjoms.2006.10.009

12. Julien Saint Amand M., Sigaux N., Gleizal A., Bouletreau P., Breton P. Chronic osteomyelitis of the mandible: A comparative study of 10 cases with primary chronic osteomyelitis and 12 cases with secondary chronic osteomyelitis. J Stomatol Oral Maxillofac Surg. 2017 Dec; 118 (6): 342-348. doi: 10.1016/j.jormas.2017.08.006

13. Marschall J.S., Flint R.L., Kushner G.M., Alpert B. Management of Mandibular Osteomyelitis With Segmental Resection, Nerve Preservation, and Immediate Reconstruction. J Oral Maxillofac Surg. 2019 Jul; 77 (7): 1490-1504. doi: 10.1016/j.joms.2019.01.036

14. Baur D.A., Altay M.A., Flores-Hidalgo A., Ort Y., Quereshy F.A. Chronic osteomyelitis of the mandible: diagnosis and management--an institution's experience over 7 years. J Oral Maxillofac Surg. 2015 Apr; 73 (4): 655-65. doi: 10.1016/j.joms.2014.10.017

15. Sood R., Gamit M., Shah N., Mansuri Y., Naria G. Maxillofacial Osteomyelitis in Immunocompromised Patients: A Demographic Retrospective Study. J Maxillofac Oral Surg. 2020 Jun; 19 (2): 273-282. doi: 10.1007/s12663-019-01201-4

16. Hannan C.M., Attinger C.E. Special considerations in the management of osteomyelitis defects (diabetes, the ischemic or dysvascular bed, and irradiation). Semin Plast Surg. 2009 May; 23 (2): 132-40. doi: 10.1055/s-0029-1214165

17. Lin H.T., Tsai C.S., Chen Y.L., Liang J.G. Influence of diabetes mellitus on deep neck infection. J Laryngol Otol. 2006 Aug; 120 (8): 650-4. doi: 10.1017/S0022215106001149

18. Cheng N.C., Tai H.C., Chang S.C., Chang C.H., Lai H.S. Necrotizing fasciitis in patients with diabetes mellitus: clinical characteristics and risk factors for mortality. BMC Infect Dis. 2015 Oct 13; 15: 417. doi: 10.1186/s12879-015-1144-0

19. Yadav S., Malik S., Mittal H.C., Puri P. Chronic suppurative osteomyelitis of posterior maxilla: A rare presentation. J Oral Maxillofac Pathol. 2014 Sep-Dec; 18 (3): 481. doi: 10.4103/0973-029X.151364

20. Ueta E., Osaki T., Yoneda K., Yamamoto T. Prevalence of diabetes mellitus in odontogenic infections and oral candidiasis: an analysis of neutrophil suppression. J Oral Pathol Med. 1993 Apr; 22 (4): 168-74. doi: 10.1111/j.1600-0714.1993.tb01051.x

21. Kasperk C., Georgescu C., Nawroth P. Diabetes Mellitus and Bone Metabolism. Exp Clin Endocrinol Diabetes. 2017 Apr; 125 (4): 213-217. doi: 10.1055/s-0042-123036

22. Giles A.J., Hutchinson M.N.D., Sonnemann H.M., Jung J., Fecci P.E., Ratnam N.M., Zhang W., Song H., Bailey R., Davis D., Reid C.M., Park D.M., Gilbert M.R. Dexamethasone-induced immunosuppression: mechanisms and implications for immunotherapy. J Immunother Cancer. 2018 Jun 11; 6 (1): 51. doi: 10.1186/s40425-018-0371-5

23. Barshes N.R., Goodpastor S.E., Goss J.A. Pharmacologic immunosuppression. Front Biosci. 2004 Jan 1; 9: 411-20. doi: 10.2741/1249

24. Perez A., Jansen-Chaparro S., Saigi I., Bernal-Lopez M.R., Mińambres I., Gomez-Huelgas R. Glucocorticoid-induced hyperglycemia. J Diabetes. 2014 Jan; 6 (1): 9-20. doi: 10.1111/1753-0407.12090