Post-COVID-19 Extensive Maxillary Actinomycotic Osteonecrosis: A Rare Case Report

Abstract

Osteonecrosis can be seen in post-Covid-19 patients due to the damage to their immune systems and the medications they take. This case report deals with the diagnosis, treatment and follow-up of actinomycotic osteonecrosis of the maxilla, which is one of the very rare post-covid conditions. The medical history of the 48-year-old patient, who had received treatment for Covid-19 in the intensive care unit about 1 year ago and had no systemic disease, revealed left palatinal and buccal bone exposure, suppuration and oroantral relationship. After limiting the lesion with pentoxifylline and alpha tocopherol, all necrotic bone tissue was removed and the area was closed with Bichat fat pad. The removed tissue was sent for histopathologic and microbiologic examination. The area was closed primerally. Postoperative follow-up of 1 year was completed and no new lesion was observed. Microbiologic evaluation was positive for actinomyces. This case may shed light on clinicians to give importance to the follow-up of patients with Covid-19 and its variants, especially if they have a history of hospitalization, to provide a differential diagnosis for PC-RONJ even if the interval is long, and not to skip the microbiological evaluation stage.

Keywords

• Post Covid-19
• Actinomycosis
• Osteonecrosis

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