Delphine Mauprivez
The diagnosis of primary chronic osteomyelitis of the jaw was made in a 15-year-old girl with a history of recurrent severe orofacial swelling based on clinical symptoms, histological analysis, and imaging modalities. The results of the initial microbiological samples were inconclusive. She used NSAIDs and several empirical antibiotic treatments for three years without achieving full remission. The ultimate diagnosis of bacterial chronic osteomyelitis of the jaw could only be made by MALDI-TOF (Matrix-Assisted Laser Desorption/Ionization-Time of Flight) analysis after further numerous microbiological bone samples with suitable methods. To reduce treatment failure, it must be managed using a multidisciplinary strategy comprising oral and maxillofacial surgeons, infectiologists, and microbiologists. The entire radiographic resolution of the CBCT (Cone Beam Computed Tomography) and the normalisation of laboratory values were obtained with antibiotic therapy without surgery for six months. A follow-up of two years revealed no relapses. In particular, in rare and clinically perplexing types of this infection, modern microbiological research and sample procedures are essential for the appropriate diagnosis and management of osteomyelitis of the jaw.
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