Abstract
Here, we report a case in which refractory mandibular osteomyelitis was successfully managed with continuous local antibiotic perfusion（CLAP）. A 66‒year‒old male, who had been started on maintenance hemodialysis 20 years ago, was admitted to hospital for a high fever and chills 18 days after the extraction of dental caries. Although he received antibiotic therapy for 3 days in the hospital, his general condition did not improve. He was transferred to our university hospital and underwent emergency drainage of an abscess from the left lower jaw to left temporal head. However, contrast‒enhanced CT（performed on day 53）showed mandibular sequestration. As his general condition and comorbidities precluded surgical interventions, we decided to apply CLAP. After 2 weeks’ CLAP without any adverse events, his general condition improved, and he was transferred to a rehabilitation hospital. Five months later, the infection had not relapsed. In addition, his mandible had recovered from the sequestration. This case report indicates that CLAP is a promising procedure for bone and soft tissue infections in maintenance hemodialysis patients.
