Osteomyelitis of the Mandible Following Fracture in a Patient With Unknown HIV Infection

Aim Osteomyelitis is a condition caused by an infected bone process. Host defences are vital in its progression and must be investigated for possible systemic diseases. A patient with osteomyelitis of the mandible following fracture and unknown human immunodeficiency virus (HIV) infection is reported. The challenges of diagnosis and the complexities of effective management stand out. Material and Methods A 50‐year‐old man who suffered a bicycle accident, resulting in a right mandibular body fracture and a high bilateral condylar fracture. The condylar fractures were treated conservatively, and the mandibular body was treated using open reduction and internal fixation. The patient was discharged. However, 25 days post‐surgery, there was trismus and extraoral fistula with purulent drainage. A computed tomography scan revealed signs of osteomyelitis. A new surgery was done for debridement, fixation material change, bone sequester removal and osteoplasty. After the new approach, the patient did not develop well; additionally, he presented candidiasis on the tongue and palate. New laboratory tests revealed an HIV‐positive sample. The patient claimed to be unaware of the condition and was referred to begin antiretroviral therapy. Results The infectious condition improved 60 days following antiretroviral treatment. After 3 years of follow‐up, a reassessment was required because of a new infection. The last postoperative CT scan showed bone repair. Conclusions There have been few reports associating osteomyelitis following mandibular fracture and HIV. However, the surgical treatment of fractures does not differ in HIV‐positive patients. The importance of preoperative tests for prognosis prediction is highlighted.