Related Experiment Videos

Mandibular osteomyelitis in children mimicking juvenile recurrent parotitis

Riitta T Saarinen1, Kaija-Leena Kolho, Risto Kontio

  • 1Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki University, Helsinki, Finland. riitta.t.saarinen@hus.fi

International Journal of Pediatric Otorhinolaryngology
|April 15, 2011
PubMed

Insights

Mandibular osteomyelitis in children can mimic juvenile recurrent parotitis. Early MRI is crucial for accurate diagnosis and effective treatment of this severe bone infection.

Area of Science:

  • Pediatric Infectious Diseases
  • Oral and Maxillofacial Surgery
  • Pediatric Radiology

Background:

  • Juvenile recurrent parotitis is a common clinical diagnosis in children.
  • Mandibular osteomyelitis is a serious condition that can present with similar symptoms.
  • Misdiagnosis can lead to significant delays in appropriate treatment.

Purpose of the Study:

  • To identify and describe pediatric cases of mandibular osteomyelitis initially misdiagnosed as juvenile recurrent parotitis.
  • To highlight the importance of advanced imaging in differentiating these conditions.
  • To review the diagnostic challenges and treatment outcomes.

Main Methods:

  • Retrospective review of pediatric patient data from Helsinki University Central Hospital (1998-2010).
  • Inclusion criteria: initial diagnosis of recurrent parotitis, confirmed later as mandibular osteomyelitis.
  • Analysis of diagnostic delays, imaging findings (MRI), microbiological cultures, and treatment regimens.

Main Results:

  • Six pediatric cases (5-17 years) of mandibular osteomyelitis were identified, initially diagnosed as recurrent parotitis.
  • Diagnostic delays ranged from 1.5 months to 6 years, with final diagnosis confirmed by MRI.
  • Bacterial cultures in four cases revealed Actinomyces or Streptococcus viridans; treatment included antibiotics, hyperbaric oxygen, debridement, and bisphosphonates in one case.

Conclusions:

  • Symptoms of juvenile parotitis and mandibular osteomyelitis can be easily confused.
  • Mandibular osteomyelitis requires aggressive, lengthy treatment, unlike symptomatic management for parotitis.
  • Magnetic Resonance Imaging (MRI) is essential for accurate diagnosis in unclear or persistent cases.
Abstract

Related Concept Videos

Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
Tonsillitis I: Introduction01:30

Tonsillitis I: Introduction

Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
Etiology
Three primary contributing factors have been identified.
Poliomyelitis01:17

Poliomyelitis

Poliomyelitis is caused by poliovirus, a small, non-enveloped, positive-sense RNA virus of the Picornaviridae family and Enterovirus genus. Transmission occurs primarily via the fecal-oral route, often through ingestion of contaminated water or food. The virus initially replicates in the oropharynx and intestinal mucosa, particularly in lymphoid tissues such as the tonsils, Peyer’s patches, and regional lymph nodes. Primary viremia follows, allowing dissemination throughout the body.In most...
Acute Pharyngitis01:30

Acute Pharyngitis

Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
Bacterial Meningitis II: Pathophysiology01:26

Bacterial Meningitis II: Pathophysiology

Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
Bacterial Meningitis01:24

Bacterial Meningitis

Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...