TITLE:
Septic Arthritis of the Temporomandibular Joint without an Apparent Source of Infection: A Case Report
AUTHORS:
Daisuke Suda, Hiroyuki Takatsuji, Naoaki Saito, Akinori Funayama, Kanae Niimi, Tadaharu Kobayashi
KEYWORDS:
Septic Arthritis, Temporomandibular Joint, No Apparent Source of Infection
JOURNAL NAME:
Open Journal of Stomatology,
Vol.7 No.4,
April
30,
2017
ABSTRACT: Septic arthritis of the temporomandibular joint (TMJ) is a rare disease that is characterized by preauricular pain, edema, malocclusion, trismus and abscess formation in the TMJ region. An 85-year-old male visited our hospital with the complaint of left-sided TMJ swelling, pain and trismus. Septic arthritis of the left TMJ was diagnosed on the basis of considerable elevation of CRP (Creactive proteins) and CT imaging findings. The patient was treated with oral Faropenem at 450 mg daily, but CRP increased three days after the initial visit. He was hospitalized and treated with intravenous administration of cefazolin at 2 g and clindamycin at 1.2 g daily for six days. Propionibacterium species and Veillonella species grew in a culture of the joint aspirate, but there was no apparent source of infection. After acute infectious symptoms had passed, the patient was treated with oral amoxicillin at 750 mg daily for eight weeks and was instructed to do jaw opening exercise. The patient was discharged on the 11th hospital day. After three weeks of the hospital discharge, the patient healed completely. To avoid serious complications, clinicians should include septic arthritis of the TMJ in the differential diagnosis of preauricular pain, trismus and swelling.