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Maxillary Osteomyelitis with Candidiasis due to Extraction in Uncontrolled Diabetes State-A Case Report

Laxmi Shetty,Deepak Kulkarni,Archana Anshuman Gupta*,Bhushan Gawande

Background: The uncontrolled diabetes is fast growing epidemic in India. This disease if missed before extraction will cause the patient to lose their maxillary bone as reported in this case report. The opportunistic candida infection was giving the diagnostic dilemma. The radiographs revealed osteolytic changes with destruction of the left maxilla. Sequestrum due to osteomyelitis was diagnosed and sequestrectomy was performed. The uncontrolled diabetes status improved post operatively only after sequestrum was removed. The patient was rehabilated with an obturator for the left maxillary region.

Case description: A 56 year female patient had undergone extraction in uncontrolled diabetes state at a local dentist who reported at our department with osteomyelitis and candidiasis of left maxilla. There was a situation of diagnostic dilemma for treating the uncontrolled diabetes and surgical management. The computed tomography revealed lytic destruction of the left maxilla. Sequestrectomy was the solution which reduced her blood sugar level and healing occured uneventfully.

Conclusion: An uncontrolled diabetic state is always a relative contraindication forextraction. The patient?s blood sugar level should be in controlled state before extraction. The osteomyelitis with candidiasis was induced due to extraction causing the destruction of left maxilla. Sequestrectomy cured the patient of the progressive osteomyelitis. It is of paramount significance that the negligence by the local dentist who performed the extraction in uncontrolled diabetic condition caused the loss of the left maxilla. The effective case history taken prior to extraction would have prevented the patient from all complications.