A 52-Year-Old Man With a Large Jaw Opening

Laith Mahmoud Abdulhadi, BDS, CES, DDS

Disclosures

July 13, 2016

Physical Examination and Workup

The patient was well-built and febrile. Cervical lymph nodes were palpable. Intraorally, a large opening was undermined by mucosal elevation, located at the left retromolar area near the ramus of the mandible.

Figure 1.

Figure 2.

Radiographic examination of the mandible showed the presence of an extensive radiolucent area located at the posterior part of the mandible extending to the entire left ramus, except for the condyle and coronoid holding bone segment (Figures 1, 2). The border of the lesion in the remaining bone was distinct but irregular.

Acid-fast bacillus smear (AFB) findings taken from the lesion were negative. Laboratory findings revealed an elevated erythrocyte sedimentation rate (ESR) and a positive purified protein derivative (PPD) test. Microbial culture findings of the discharge were positive for AFB after 5 weeks of incubation.

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