Septic arthritis of the temporomandibular joint as a complication of acute otitis media in a child: A rare case and the importance of real-time PCR for diagnosis

Int J Pediatr Otorhinolaryngol. 2015 Nov;79(11):1942-5. doi: 10.1016/j.ijporl.2015.08.014. Epub 2015 Aug 15.

Abstract

We document the case of a 7-year-old boy who presented with pain in his left ear and trismus after a diagnosis of acute otitis media one week previously. His blood inflammatory markers were raised and magnetic resonance imaging (MRI) showed significant left temporomandibular joint effusion and partial attenuation of the left mastoid. A clinical diagnosis of septic arthritis of the TMJ was made and the patient was commenced on broad-spectrum antibiotics. Analysis using real time PCR enabled identification of the offending organism, confirmation of the diagnosis and antibiotic treatment to be specifically tailored for treatment.

Keywords: Diagnostic; Real time PCR; Septic arthritis; TMJ; Therapy.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Anti-Bacterial Agents / therapeutic use
  • Arthritis, Infectious / diagnosis*
  • Arthritis, Infectious / microbiology
  • Arthritis, Infectious / therapy
  • Child
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Otitis Media / complications*
  • Otitis Media / diagnosis
  • Otitis Media / microbiology
  • Otitis Media / therapy
  • Real-Time Polymerase Chain Reaction
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / microbiology
  • Streptococcal Infections / therapy
  • Streptococcus pyogenes / isolation & purification*
  • Temporomandibular Joint Disorders / diagnosis
  • Temporomandibular Joint Disorders / etiology*
  • Temporomandibular Joint Disorders / therapy

Substances

  • Anti-Bacterial Agents