Recently, a number of hospitals in Ho Chi Minh City such as Central Dentistry, Ear, Nose and Throat, and Cho Ray received many patients with necrosis of the bones of the skull and jaw, and two cases died.
According to Associate Professor Tran Minh Truong, former Deputy Director of Cho Ray Hospital, Chairman of the Ho Chi Minh City Head and Neck Surgery Association, based on the patient’s clinical manifestations and searching for documents around the world, doctors determined
Common symptoms
According to Associate Professor Truong, patients reported pain in the face, teeth, and palate during the period of Covid-19 infection, then continued to progress and persist for a long time, without decreasing.
The patient entered Cho Ray Hospital with symptoms of headache, eye swelling, and right forehead swelling and was later determined to have facial necrosis.
Patients in Ho Chi Minh City mainly have bone necrosis in the maxillofacial area.
Osteoarthritis of the skull base is rarer and can easily affect life.
Danger level
The first two patients went to Cho Ray Hospital. The doctors finished sinus surgery and the patients got better, but the x-ray images showed abnormal bone necrosis.
Among patients in Ho Chi Minh City, there was a case of a sinus fungal infection and the fungus became invasive, causing bone destruction. After tooth extraction, the patient became blind.
According to Dr. Tuan, if the necrotic bone is not removed and surgically removed, it will become a colony of bacteria, which can lead to septic shock and life-threatening blood infection.
In patients with cranial osteonecrosis, if the infection penetrates the brain, it will cause meningitis and brain abscess, leading to death.
The cause to the illness
Dr. Le Quoc Hung, Head of the Department of Tropical Diseases, Cho Ray Hospital, said that the cause of bone destruction is often due to vascular occlusion, reduced blood supply leading to necrosis, or may be due to external factors such as microorganisms.
Up to now, experts have not been able to confirm whether this disease is related to Covid-19 or not.
According to Dr. Tuan, medical literature suggests 4 risk factors for maxillary osteonecrosis.
In India, some experts believe that the cause of fungal infection leading to bone necrosis is due to the patient having to use steroids for treatment while hospitalized.
Arunaloke Chakrabarti, a microbiology expert at the Indian Institute of Medical Education and Research, said many doctors were prescribing steroids in large quantities, far exceeding the recommendations of the World Health Organization (WHO).
In the context of increasing cases, Director of Ho Chi Minh City Department of Health Tang Chi Thuong said he will set up a professional council with about 20-30 experts, scheduled for a conference on July 21 to evaluate the disease.
Treatment, recommendations
The principle of treating necrotic bone is to surgically remove this bone, then attack with antibiotics and antifungals for at least 3 weeks, possibly lasting up to 6 months, while monitoring the risk of recurrence.
After being infected with Covid, if patients have symptoms such as headache, molar pain, facial swelling… they need to see a doctor.