amphotericin-b and Temporomandibular-Joint-Disorders

The aim of this report was to present the first known case of coccidioidomycosis involving the temporomandibular joint, review the literature regarding dissemination to the mandible, and to provide treatment recommendations for this challenging condition.. Coccidioidomycosis of the mandibular condyle was identified in a 30-year-old Somali male residing in Arizona. Due to the difficulty of surgical access and the anticipated temporomandibular joint morbidity of radical condylar debridement, primary medical management was performed.. Marked symptomatic improvement was observed after 10 days of IV antifungal therapy. Resolution of the abscess with residual bony destruction was observed on CT scan. Based on the results of this patient and review of the literature, an algorithm is presented to help guide management of coccidioidomycosis dissemination to the mandible.. Prolonged antifungal therapy should be attempted for initial management of a Coccidioides abscess involving the condyle with early surgical intervention reserved for the more easily accessible and less functionally compromising portions of the mandible.

Topics: Abscess; Adult; Amphotericin B; Coccidioidomycosis; Drug Therapy, Combination; Fluconazole; Humans; Infusions, Intravenous; Long-Term Care; Male; Osteomyelitis; Temporomandibular Joint Disorders; Tomography, X-Ray Computed

We report a case of aspergillosis in the right temporomandibular joint (TMJ) with a history of parotid carcinoma and post-irradiation otitis. Previous treatment attempts with surgery and antibiotics were unsuccessful. Radical debridement of the glenoid fossae, supplemented with amphotericin B and adjunct hyperbaric oxygen (HBO) therapy, was provided to resolve the symptoms. This case report highlights the need to be aware of the possibility of invasive mycosis in immunocompromised patients.

Topics: Aged; Amphotericin B; Antifungal Agents; Aspergillosis; Carcinoma, Squamous Cell; Humans; Hyperbaric Oxygenation; Male; Osteoradionecrosis; Parotid Neoplasms; Radiotherapy; Temporomandibular Joint; Temporomandibular Joint Disorders; Treatment Outcome