Oral surgery complication resulting from undiagnosed common variable immunodeficiency: a case report

This report aims to present an interdisciplinary approach to diagnosing and treating a case of Common Variable Immunodeficiency (CVID), an inborn error of immunity, resulting in successive complications following a third molar extraction procedure.

The patient, a 37-year-old Caucasian female, sought a specialist for the extraction of an impacted lower third molar associated with dentigerous cyst. Due to the possibility of mandibular fracture, a bone fixation system was used in the region. However, she experienced recurrent infections following the procedure despite various treatments and hospitalizations, and these infections could not be explained by any factors. The diagnosis of CVID was established through exclusionary factors, low immunoglobulin levels, and comprehensive allergy assessments by an immunologist. Resolution of the patient's condition and discharge were achieved only after removing the fixation system and implementing monthly immunoglobulin infusions.

CVID is often diagnosed late, resulting in significant economic, social, and health burdens, including recurrent hospitalizations, allergies, and increased risk of malignancy. This case underscores the importance of considering CVID in patients presenting with unexplained recurrent infections following oral and maxillofacial surgeries. Additionally, it highlights the necessity of a multidisciplinary approach for effectively managing patients with CVID.