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Maxillary Osteomyelitis with an Incidental Diagnosis of Maxillary Diffuse Large B-Cell Lymphoma: A Case Report

机译:上颌骨骨髓炎伴上颌窦弥漫性大B细胞淋巴瘤的偶然诊断:一例报告

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摘要

Raoultella planticola osteomyelitis is rarely reported in the literature. The most likely source in our case is the oral microbiome secondary to the tooth extraction. Herein we present a case of Raoultella planticola osteomyelitis of the jaw that leads to the diagnosis of diffuse large B-cell lymphoma (DLBCL) of the jaw. A 75-year-old male with no significant medical history, presented to the emergency department with right upper jaw pain after he had a tooth extraction a week before his presentation. Computed tomography (CT) scan of the face showed concerns of right maxillary osteomyelitis with soft tissue swelling and prominent cervical lymph nodes. He underwent a bone biopsy of the maxilla and was started on intravenous ampicillin-sulbactam. His bone culture grew pan-sensitive Raoultella planticola. in addition to that, his bone biopsy revealed diffuse large B-cell lymphoma of the jaw. The patient underwent staging imaging, and he was found to have metastasis to the liver. He was started on chemotherapy and had a good response. In conclusion, Raoultella planticola osteomyelitis is extremely rare. The diagnosis of maxillary DLBCL can be a challenge. Fortunately, our patient had an infection at the same site that led to the diagnosis of DLBCL.
机译:文献中很少报道植物性劳尔氏菌骨髓炎。在我们的案例中,最可能的来源是继拔牙后的口腔微生物组。在这里,我们介绍一例颌骨植物拉乌尔特氏菌骨髓炎,可导致颌骨弥漫性大B细胞淋巴瘤(DLBCL)的诊断。一名75岁的男性,无明显病史,在出诊前一周拔牙后就诊于急诊科,右上颚疼痛。面部计算机断层扫描(CT)扫描显示,右上颌骨髓炎伴软组织肿胀和颈淋巴结突出。他接受了上颌骨的活检,并开始静脉内使用氨苄西林舒巴坦。他的骨骼培养物生长出对泛敏感的植物毛豆。除此之外,他的骨活检还显示了颌骨弥漫性大B细胞淋巴瘤。病人接受了分期成像,发现他已经转移到肝脏。他开始接受化疗,反应良好。总之,植物拉乌尔氏菌骨髓炎极为罕见。上颌DLBCL的诊断可能是一个挑战。幸运的是,我们的患者在同一部位感染,导致诊断为DLBCL。

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