Pharmacological Treatment of Primary Chronic Osteomyelitis

A Case Report

Authors

  • Jhosepher Previati de Oliveira University of São Paulo https://orcid.org/0000-0002-4724-9247
  • Rodrigo Chenu Migliolo University of São Paulo
  • José Benedito Dias Lemos University of São Paulo
  • Márcia Maria de Gouveia University of São Paulo

DOI:

https://doi.org/10.5935/2525-5711.20230210

Keywords:

Osteomyelitis, Pamidronate, Treatment Outcome

Abstract

Paracoccidioidomycosis (PCM) is an infection caused by the dimorphic fungus Paracoccidioides brasiliensis, which has a predilection for hot and humid places; thus, this disease has a particularly high incidence in Brazil. Children, adolescents, and adults can be affected by acute/subacute or chronic PCM. To describe the clinical-pathological characteristics and treatment of a case of chronic PCM oral lesion. The oral examination of a 57-year-old male patient revealed moriform stomatitis on the perioral region (irregular shape), lips vermilion, and continuity with the jugal mucosa. After an incisional biopsy, the anatomopathological analysis confirmed the diagnosis of PCM. The patient was referred to a reference center for tropical diseases and treated with 400mg sulfamethoxazole and 80mg trimethoprim twice a day. Since some adverse effects were observed, the treatment was switched to 100mg of itraconazole twice a day. The follow-up examination revealed accelerated healing of the oral lesions and reduction of the inflammatory process. Stomatologists play a key role in the identification of PCM oral lesions and referral for adequate treatment by an infectious disease specialist.

Author Biographies

Jhosepher Previati de Oliveira, University of São Paulo

Resident, Department of Oral and Maxillofacial Surgery and Traumatology at the University Hospital of the University of São Paulo

Rodrigo Chenu Migliolo, University of São Paulo

Resident, Department of Oral and Maxillofacial Surgery and Traumatology at the University Hospital of the University of São Paulo

José Benedito Dias Lemos, University of São Paulo

Professor, Department of Surgery, Prosthesis and Traumatology, Faculty of Dentistry, University of São Paulo

Márcia Maria de Gouveia, University of São Paulo

Staff, Department of Oral and Maxillofacial Surgery and Traumatology at the University Hospital of the University of São Paulo

References

Araújo MS, Sousa SCOM, Correia D. Evaluation of cytopathologic exam for diagnosis of oral chronic paracoccidioidomycosis. Rev Soc Bras Med Trop. 2003 May/Jun;36(3):427-30.

Arruda JAA, Schuch LF, Abreu LG, Silva LVO, Mosconi C, Monteiro JLGC, et al. A multicentre study of oral paracoccidioidomycosis: analysis of 320 cases and literature review. Oral Dis. 2018 Nov;24(8):1492-502.

Góes AM, Silva LSS, Araújo SA, Cruz SG, Siqueira WC, Pedroso ERP. Paracoccidioidomycosis disease (Lutz-Splendore-Almeida): etiology, epidemiology, and pathogenesis. Rev Med Minas Gerais. 2014;24(1):58-63.

Guimarães TF, Guilarde AO, Godoy CSM, Rosa e Silva MG, Camargo DG, Coutinho JVSC, et al. Paracoccidioidomicose como diagnóstico diferencial de neoplasia em SNC. Braz J Infect Dis. 2022;26(Suppl 1):101736.

Marques SA, Lastória JC, Camargo RMP, Marques MEA. Paracoccidioidomycosis: acute-subacute clinical form, juvenile type. An Bras Dermatol. 2016;91(3):384-6.

Moreira APV. Paracoccidioidomicose: histórico, etiologia, epidemiologia, patogênese, formas clínicas, diagnóstico laboratorial e antígenos. Bol Epidemiol Paul. 2008;5(51):1-17.

Neville BW, Damm DD, Allen CM, Bouquot JE. Patologia Oral & Maxilofacial. Rio de Janeiro: Elsevier; 2016.

Macedo MP, Leite DFC, Souza CDL, Lima LOH, Lopes FF. Paracoccidioidomycosis in oral cavity - case report. Odontol Clín-Cient. 2016;15:1-4.

Rosario JS, Toledo PF, Deco CP, Nicolau RA, Canettieri ACV. Diagnóstico e tratamento de paracoccidiodomicose: relato de caso clínico. Rev Univap. 2016;22:641.

Rubin E, Farber JL. Patologia. 3rd ed. Rio de Janeiro: Guanabara Koogan; 2002.

Shikanai-Yasuda MA, Mendes RP, Colombo AL, Telles FQ, Kono A, Paniago AMM, et al. II Brazilian guidelines for the clinical management of paracoccidioidomycosis. Epidemiol Serv Saúde. 2018 Aug;27(spe):e0500001.

Shikanai-Yasuda MA, Telles Filho FQ, Mendes RP, Colombo AL, Moretti ML. Guideliness in paracoccidioidomycosis. Rev Soc Bras Med Trop. 2006 May/Jun;39(3):297-310.

Shikanai-Yasuda MA. Paracoccidioidomycosis treatment. Rev Inst Med Trop Sao Paulo. 2015;57(Suppl 19):31-7.

Silva CO, Almeida AS, Pereira AAC, Sallum AW, Hanemann JAC, Tatakis DN. Gingival involvement in oral paracoccidioidomycosis. J Periodontol. 2007 Jul;78(7):1229-34.

Silva MJA, Cruz EC, Gama GCB, Siqueira AS. Ecoepidemiology of paracoccidioidomycosis: a narrative review of the literature. Res Soc Develop. 2021;10:e31810918182.

Souza MCA, Souza ERP, Côrtes PPR, Côrtes Júnior JCS, Vilagra SMBW, Costa EMA. Resolutive care of paracoccidioidomycosis in a Basic Health Unit. Case report. Rev Bras Med Fam Comunidade. 2018;13(40):1-7.

Souza SP, Jorge VM, Xavier MO. Paracoccidioidomycosis in southern Rio Grande do Sul: a retrospective study of histopathologically diagnosed cases. Braz J Microbiol. 2014;45(1):243-7.

Trindade AH, Meira HC, Pereira IF, Lacerda JCT, Mesquita RA, Santos VR. Oral paracoccidioidomycosis: retrospective analysis of 55 Brazilian patients. Mycoses. 2017 Aug;60(8):521-5.

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Published

2023-01-10

How to Cite

1.
Oliveira JP de, Migliolo RC, Lemos JBD, Gouveia MM de. Pharmacological Treatment of Primary Chronic Osteomyelitis: A Case Report. J Oral Diagn [Internet]. 2023 Jan. 10 [cited 2024 Sep. 19];8:1-7. Available from: https://jordi.com.br/revista/article/view/6

Issue

Vol. 8 (2023)

Section

Case Report

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Copyright (c) 2023 Jhosepher Previati de Oliveira, Rodrigo Chenu Migliolo, José Benedito Dias Lemos, Márcia Maria de Gouveia

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This work is licensed under a Creative Commons Attribution 4.0 International License.