Mandibular osteomyelitis and tooth exfoliation following zoster-CMV co-infection.

Abstract

Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely infrequent and sporadic, with only 39 cases being reported in the literature. We report an additional case of mandibular osteomyelitis and spontaneous tooth exfoliation following herpes zoster infection, which occurred in the left mandible of a 70-year-old diabetic man; however, our case also showed CMV co-infection. The role of CMV in the pathogenesis of the osteonecrosis remains uncertain. Awareness of the possibility of CMV co-infection in various oral diseases including oral ulcers, Kaposi's sarcoma, and herpes zoster infections especially in immunocompromised patients is important, since spread of the CMV can easily occur to other sites with potentially fatal consequences. Early diagnosis can lead to effective treatment and prevention of complications.

• Authors: Shabnum Meer, Hedley Coleman, Mario Altini, Terence Alexander
• Journal: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics (Oral Surg Oral Med Oral Pathol Oral Radiol Endod) Vol. 101 Issue 1 Pg. 70-5 (Jan 2006) ISSN: 1528-395X [Electronic] United States
• PMID: 16360610 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Cytomegalovirus Infections (complications)
• Herpes Zoster (complications)
• Humans
• Male
• Mandibular Diseases (etiology)
• Osteomyelitis (etiology)
• Prediabetic State (complications)
• Superinfection
• Tooth Loss (etiology)
• Trigeminal Nerve Diseases (complications)