J Korean Assoc Oral Maxillofac Surg.  2015 Dec;41(6):357-360. 10.5125/jkaoms.2015.41.6.357.

Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review

• Song JM
• Seo JS
• Lee JY

• KMID: 2133186
• DOI: http://doi.org/10.5125/jkaoms.2015.41.6.357

Abstract

Herpes zoster virus (HZV) infections are caused by reactivation of the varicella zoster virus. Reactivation symptoms commonly affect the thoracolumbar trunk, and rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions appear proximal to the innervation area. This condition may be associated with exfoliation of the teeth and osteonecrosis of the jawbone. We report a case of mandibular osteomyelitis after herpes zoster infection and we present a review of the literature on mandibular-branch involvement of HZV-related osteonecrosis.

Keyword

Herpes zoster; Osteonecrosis; Trigeminal nerve

MeSH Terms

Herpes Zoster*
Herpesvirus 3, Human
Osteomyelitis
Osteonecrosis*
Tooth
Trigeminal Nerve*

Figure

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  Fig. 1 Preoperative clinical view. A. Extraoral view. B. Intraoral view.

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  Fig. 2 Preoperative radiographs. A. Preoperative panoramic view. B. Preoperative computed tomography view.

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  Fig. 3 Sequestrectomy and teeth removal were conducted. A sound bone bed was exposed and primarily closed.

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  Fig. 4 Histologic findings. A. Eosinophilic intranuclear inclusion bodies and multinucleated giant cells are observed (H&E staining, ×400). B. Stained cells were CD68+ (IHC staining, ×200). C. Scattered neutrophils, lymphocytes, and plasma cells, which indicated acute and chronic inflammation, were observed (H&E staining, ×400).

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