Chronic recurrent multifocal osteomyelitis of the spine and mandible: case report and review of the literature.
At initial presentation, chronic recurrent multifocal osteomyelitis may mimic acute hematogenous osteomyelitis; however, cultures of affected bone are sterile. Nuclear scintigraphy identifies additional foci of involvement that present concurrently or sequentially. Unlike acute bacterial osteomyelitis, chronic recurrent multifocal osteomyelitis seems unaffected by antibiotic therapy and typically responds to treatment with antiinflammatory drugs. Surgical decortication has been reported for refractory cases. The case presented here illustrates the rare involvement of the mandible after initial presentation in the spine of a 4-year-old girl and the refractory nature of the disease over 6 years despite treatment with various medical and surgical therapies.
Chun
Colleen S Y
CS
Department of Pediatrics, Northwest Permanente, Portland, Oregon, USA. chunc@ohsu.edu
D019386:Alendronate / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008336:Mandibular Diseases / Q000175:diagnosis / Q000628:therapy; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D012008:Recurrence; D013122:Spinal Diseases / Q000175:diagnosis / Q000628:therapy
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007371:Interferon-gamma; D011241:Prednisone; D019386:Alendronate