CHRONIC SUPPURATIVE OSTEOMYELITIS IN A PATIENT WITH AUTISM SPECTRUM DISORDER: CHALLENGES IN CLINICAL MANAGEMENT

The present study reports the challenges faced during the diagnosis and treatment of chronic suppurative osteomyelitis in a patient with autism spectrum disorder (ASD). A 23-year-old woman intern in a special care institution attended the special care dental clinic of the authors with an unusual periodontal lesion involving tooth 47. Tooth extraction was performed with curettage of the surrounding structures for histopathologic examination. Microscopic examination diagnosed an aggressive juvenile periodontitis leading to suppurative osteomyelitis. Based on the pathologic report, a tomographic examination was performed and revealed the extension of the bone destruction as well as bone sequestrum. The patient was referred for surgical approach under general anesthesia to remove all necrotic and infected bone. After 1 year of the diagnosis the patient still under treatment without complete resolution of the lesion.