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Methicillin-resistant Staphylococcus aureus (MRSA)-associated juvenile osteomyelitis of mandible: a rare variant
  1. Rabin Chacko1,
  2. Saurabh Kumar1,
  3. Valsan Philip Verghese2 and
  4. Arun Paul Charllu1
  1. 1Dental and Oral Surgery, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
  2. 2Pediatric Infectious Diseases, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
  1. Correspondence to Dr Saurabh Kumar; dr.s.kumar.bds{at}


Mandibular osteomyelitis in paediatric population presents as painful swelling with progressive trismus. Often the aetiology for this form of progressive osteomyelitis is inconclusive. The infective aetiology in this condition is difficult to assign as bone tissue culture is found to be seldom positive. We present a case of an 11-year-old girl, with hearing and speech impairment, who presented with report of painful right-sided mandibular swelling with progressive trismus. Clinical, radiographic and histopathological findings were suggestive of sclerotic osteomyelitis. Bone tissue culture grew Methicillin-resistant Staphylococcus aureus, indicating a rare infective variant. Unlike the common belief, where osteomyelitic mandible needs a combination of medical and surgical management, our case was managed conservatively with only antibiotic therapy. Our patient responded well to the treatment with reduction in pain and gradual improvement in the mouth opening. Radiographically the mandibular involvement also showed complete regression.

  • infections
  • bone and joint infections
  • medical management
  • head and neck surgery
  • oral and maxillofacial surgery

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  • Contributors RC, SK, VPV identified and managed the case as well as conceived the study. SK, APC, RC contributed for the refinement of the manuscript, literature research and intellectual expertise for the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.