Garré's Sclerosing Osteomyelitis with Perimandibular Soft Tissue Inflammation and Fistula

Area of Science:

• Oral and Maxillofacial Surgery
• Radiology
• Infectious Diseases

Background:

• Garré's sclerosing osteomyelitis is a rare, nonsuppurative form of chronic osteomyelitis, typically affecting younger individuals.
• It often presents with localized bone sclerosis and periosteal reaction, commonly in the mandible.

Observation:

• A 20-year-old female presented with facial asymmetry, trismus, and a hard swelling, following a dental infection.
• Imaging revealed mandibular sclerosis, periostitis, and associated soft tissue inflammation including enlarged masticatory muscles and intramuscular fluid collection.

Findings:

• Diagnosis of Garré's osteomyelitis with superimposed fascial space infection was established based on clinical and imaging findings.
• The case presented with rare complications: fascial space infection and fistula formation, atypical for this usually nonsuppurative condition.

Implications:

• This case expands the clinical spectrum of Garré's sclerosing osteomyelitis, emphasizing the possibility of secondary infection.
• Highlights the importance of comprehensive imaging and clinical evaluation for accurate diagnosis and management of complex osteomyelitis cases.
• Underscores the rarity of fistula formation in Garré's sclerosing osteomyelitis, necessitating careful monitoring for such complications.