Trismus originating from rare fungal myositis in pterygoid muscles:A case report  

作　　者：Ling Bi Dong Wei Bo Wang Jian-Feng He Hui-Yong Zhu Hui-Ming Wang 

机构地区：[1]Department of Stomatology,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang Province,China [2]Department of Pathology,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang Province,China [3]Department of Oral and Maxillofacial Surgery,The Affiliated Hospital of Stomatology,School of Stomatology,Zhejiang University School of Medicine,and Key Laboratory of Oral Biomedical Research of Zhejiang Province,Hangzhou 310006,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2021年第23期6872-6878,共7页世界临床病例杂志

基　　金：Supported by Natural Science Foundation of Zhejiang Province,China,No.LQ19H160019;Zhejiang Provincial Basic Public Welfare Research Project,China,No.LGF19H140006;Zhejiang TCM Science and Technology Plan,China,No.2018ZA071,and No.2019ZA069;Medical Scientific Research Foundation of Zhejiang Province,China,No.2019KY379.

摘　　要：BACKGROUND Trismus is a common problem with various causes.Any abnormal conditions of relevant anatomic structures that disturb the free movement of the jaw might provoke trismus.Trismus has a detrimental effect on the quality of life.The outcome of this abnormality is critically dependent on timely diagnosis and treatment,and it is difficult to identify the true origin in some cases.We present a rare case of trismus due to fungal myositis in the pterygoid muscle,excluding any other possible pathogenesis.CASE SUMMARY The patient presented with a 2-mo history of restricted mouth opening.Computed tomography showed obvious enlargement of the left pterygoid muscles.Furthermore,the patient had trismus without obvious predisposing causes.The primary diagnosis was pterygoid myosarcoma.Consequently,lesionectomy of the left pterygoid muscle was performed.Intraoperative frozen biopsy implied the possibility of an uncommon infection.Postoperative pathologic examination confirmed myositis and necrosis in the pterygoid muscle.Fungi were detected in both muscle tissue and surrounding necrotic tissue.The patient recovered well with antifungal therapy and mouth opening exercises.The rarity of fungal myositis may be responsible for the misdiagnosis.Although the origin of pathogenic fungi is still unknown,we believe that both hematogenous spread and local invasion could be the most likely sources.To the best of our knowledge,this is the
rst case in the literature that reported fungal myositis in pterygoid muscles as the only reason that results in trismus.CONCLUSION Surgeons should remain vigilant to the possibility of trismus originating from fungal myositis.

关 键 词：TRISMUS Fungal myositis Infection IMMUNODEFICIENCY Pterygoid muscle Case report 

分 类 号：R782[医药卫生—口腔医学]