Abstract
INTRODUCTION: Garrè’s osteomyelitis (GO) is a rare inflammatory chronic disease, characterized by a periosteal reaction with bone neoformation secondary to bacterial infections of odontogenic origin. The mandible is the most affected bone structure. Most prevalent in the first and second decades of life, a little more prevalent in males. OBJECTIVE: To describe a clinical case in a pediatric patient with GO, showing diagnostic keys for the pediatrician and its clinical evolution. CASE REPORT: A 12-year-old male patient, previously healthy, started with pain in the lower dental arch, associated with an extensive carious lesion in the lower right first molar, progressing with the appearance of a tumor in the homolateral mandibular topography, it was painless and hardened. A computed tomography was performed on the face, which showed periapical lytic involvement along the lower right first and second premolars, and the adjacent external cortical bone, associated with periosteal reaction. Having raised the hypothesis of GO, the extraction of the affected tooth was realized with bone tissue biopsy, the histological study showed the presence of fibrous tissue, dilated blood vessels and intertrabecular inflammatory infiltrate. Antibiotic therapy with intravenous clindamycin for seven days. It evolved with progressive regression of the lesion, being maintained orally therapy for six weeks, suspended after complete regression. CONCLUSION: This case reinforces the importance of this condition for pediatricians. It should always be suspected when there is a dental disease. The evolution tends to be favorable, when appropriate treatment is instituted, removing the infectious focus and prescribing adjuvant antibiotic therapy.