A case of Sweet's syndrome secondary to removal of infected mandibular titanium mesh and plate

Abstract

A 67-year-old woman, who had a history of an open surgery for mandible and right knee joint fractures in a traffic accident 28 years ago, visited our hospital due to the swelling of lower jaw. Under the diagnosis of titanium mesh and plate infection, the mesh and the plate removal with debridement was performed. After operation, she realized mild erythemas on her trunk and limbs skin. On the fourth day after operation, she had a fever, increased neutrophils and the elevation of C-reactive protein (CRP). Initially, post-operative infection was suspected and an antibiotic was administered, while it was ineffective. Accordingly, the patient was referred to the Department of Internal Medicine, and subsequently to dermatology specialist for the further diagnosis of skin erythema and blood test abnormalities. Since the dermatology specialist suggested a possible clinical diagnosis as Sweet's syndrome, skin and mucosal biopsy was performed, which confirmed the diagnosis. As far as we could search, this is the first report of Sweet's syndrome followed by the surgery in oral and maxillofacial region. Since this case developed after surgery, it was difficult to distinguish it from postoperative infection or drug allergy. Keywords: Sweet's syndrome, Titanium plate, Titanium mesh, Infection, Plate removal, Erythema