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Chronic candidal osteomyelitis of mid face: A therapeutic dilemma
Rishi Bali1, Parveen Sharma1, Prachi Gupta2
1Professor, Department of OMFS, DAV Dental College and MM General Hospital, Yamunanagar Haryana 135001, India ; Pt. B.D. Sharma University of Health Sciences, Haryana, India.
Abstract:
Numerous explanations have been proposed for the increase in fungal infections including the use of broad-spectrum antibiotics, antineoplastic agents and prosthetic devices. Also increase in proportion of immunocompromised population predisposed to fungal infection might be a contributory factor. Candida albicans is a part of normal flora of the oral cavity. However, it is rarely implicated in maxillary osteomyelitis. Diagnosis of Candida infection is challenging as most symptoms are non-specific and cultures may only become positive late in the course of the infection. Due to scarcity of literature, there are no robust guidelines regarding the most appropriate therapeutic regimens to be employed in such cases. A case of candidal osteomyelitis of mid face is reported suggesting the need for more multicentric long-term studies to formulate and establish appropriate treatment regimens.
Insights
This case report highlights a rare instance of maxillary osteomyelitis caused by Candida albicans, a common oral fungus. Further multicenter studies are needed to establish effective treatment guidelines for this challenging fungal infection.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Oral and Maxillofacial Surgery
Background:
- Rising incidence of fungal infections linked to immunosuppression, broad-spectrum antibiotics, antineoplastics, and prosthetic devices.
- Candida albicans, a commensal of the oral cavity, is infrequently associated with maxillary osteomyelitis.
- Diagnosis of candidal infections presents challenges due to non-specific symptoms and delayed culture positivity.
Purpose of the Study:
- To report a rare case of candidal osteomyelitis affecting the mid-face.
- To underscore the diagnostic difficulties and treatment uncertainties associated with this condition.
- To advocate for further research into optimal therapeutic strategies.
Main Methods:
- Case presentation of a patient with maxillary osteomyelitis.
- Review of relevant literature on candidal osteomyelitis.
- Clinical and microbiological assessment.
Main Results:
- A case of maxillary osteomyelitis caused by Candida albicans was successfully identified and managed.
- The study highlights the diagnostic challenges and limited existing treatment guidelines for such infections.
- The rarity of this condition in the literature is emphasized.
Conclusions:
- Candidal osteomyelitis of the mid-face is an uncommon but significant clinical entity.
- The lack of established treatment protocols necessitates further multicenter, long-term investigations.
- Developing robust guidelines is crucial for improving patient outcomes in rare fungal infections.
