Diabetic Maxillary Osteomyelitis: A Worrisome Vulnerability-Our Experience

Osteomyelitis is inflammation of medullary cavities, haversian system and adjacent cortex of bone. It is devastating to patients when invasive.

The purpose of this study is to retrospectively review patients diagnosed with diabetic maxillary osteomyelitis and evaluate factors relating infection & diabetes.

Case records of patients diagnosed with diabetic maxillary osteomyelitis were studied. Patient's demographic data, predisposing factors, etiology, clinical features, culture sensitivity reports, microbiology, treatment and complications were studied. Diabetic status was confirmed by glycosylated hemoglobin (HbA1c) test. Duration of diabetes and anti-diabetic medication adherence was also studied.

There were 28 patients diagnosed with diabetic maxillary osteomyelitis, (23-male; 5-female). Majority of the patients (60.7%) belonged to fourth & fifth decades. Twenty (71.4%) patients had poorly controlled diabetes (HbA1c > 8%). All patients reported with random blood sugar > 200 mg/dl. Thirteen patients (46.4%) were diagnosed for diabetes on admission and 11 patients (39.3%) had poor anti-diabetic medication adherence. Predominant etiology was odontogenic infection (50%). Cases of bacterial osteomyelitis (50%) were more frequent than those of fungal osteomyelitis (32.1%). Recurrence was observed in three cases.

Non-cognizance about diabetes mellitus can prove devastating for maxillofacial region and may prove fatal for the patient.