年轻无症状患者上颌骨放线菌病:罕见病例报告

J. Pereira, D. F. B. Silva, Rebeca Cecília Vieira de Souza, Tiago João da Silva Filho, I. J. Dias, D. Gomes
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引用次数: 0

摘要

摘要本研究的目的是报告一个不寻常的病例放线菌病在上颌区域的无症状患者。一位21岁的白人男性接受了全景x线摄影和锥束计算机断层扫描分析,发现上颌左侧有一低密度病变,从上颌左中切牙延伸到上颌左第二前磨牙区域。口腔内检查发现硬腭黏膜凹陷,靠近上颌左中切牙的牙槽黏膜有瘘口,经热试验证实牙髓有活力。我们进行了根尖周围x线摄影,发现瘘管路径并非起源于上述牙齿。为了诊断目的,进行了切口活检。然而,由于显微镜检查结果不确定,四个月后,又进行了一次新的活检。组织病理学检查显示存在一菌落的微生物与丝状模式辐射玫瑰,周围多形核炎症细胞。根据形态学特征,建立放线菌病的诊断。治疗是基于抗生素治疗。感染治疗6个月后,未见复发迹象,患者仍在随访中。上颌骨放线菌病是一种罕见的感染,多见于20至60岁的男性,其治疗方法为抗生素治疗或不手术切除。
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Actinomycosis in the maxilla of a young asymptomatic patient: unusual case report
ABSTRACT The aim of this study is to report an unusual case of actinomycosis in the maxilla region of an asymptomatic patient. A 21-year-old white man was referred for the analysis of panoramic radiography and cone beam computed tomography, where it was observed the presence of a hypodense lesion on the left side of the maxilla, which extended from the maxillary left central incisor to the region of the maxillary left second premolar. During intraoral examination, a depression was observed in the hard palate mucosa, as well as a fistula in the alveolar mucosa close to maxillary left central incisor, which had pulp vitality confirmed by thermal tests. A fistulography was performed, with periapical radiography, where it was found that the fistulous path did not originate from the tooth mentioned above. An incisional biopsy was performed for diagnostic purposes. However, given the inconclusive microscopic findings, four months later, a new biopsy was performed. The histopathological examination revealed the presence of a colony of microoganisms with filamentous pattern of radiated rosette, surrounded by polymorphonuclear inflammatory cells. Based on the morphological characteristics, the diagnosis of actinomycosis was established. The treatment was based on antibiotic therapy. Six months after treatment of the infection, no signs of recurrence were observed, and the patient remains in follow-up. Actinomycosis in the maxilla is an uncommon infection with a predilection for males between the ages of 20 and 60, whose treatment is antibiotic therapy associated or not with surgical excision.
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