Local therapy of osteomyelitis of the orbit with autologous activated platelet rich plasma and gentamycin: Case report with long term results

Introduction:

Osteomyelitis is a challenging medical condition that can often only insufficiently be contained with antibiotics and surgical removal. Here, a case is presented that documents the successful local treatment of osteomyelitis with autologous activated platelet rich plasma and gentamycin preventing an imminent orbital exenteration.

Methods:

A 78-year-old woman presented in our clinic for the treatment of osteomyelitis in the right orbit. Previously, an enucleation of the left eyeball had been performed in a different clinic because of Wegener's granulomatosis manifesting in the nasal sinuses and the left orbit. Furthermore, a suppurative infection of soft tissue and bones centered in the left orbit and spreading to the right orbit was detected. Total resection of the infected tissue was declined by the patient. Thus, local treatment with autologous activated platelet rich plasma and gentamycin was initiated and repeatedly applied. The long-term course of the disease was documented during

follow-up care.

Results:

27 months after initial treatment a complete local remission could be documented during follow-up care. Radiologically and clinically no signs of recurring osteomyelitis ware detectable.

Outlook:

Therapeutical options based on alternative medical approaches are infrequently considered in medical treatment. Radical surgical removal of osteomyelitis in visible and aesthetically relevant areas is often declined by the patients. The current case report documents a successful long-term effect that encourages the application of the anti-inflammatory, antimicrobial, and beneficial effects on wound healing of autologous activated platelet rich plasma. However, controlled clinical trials are necessary to legitimate an evidence based application.

Publication History

Publication Date:
23 April 2019 (online)