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A Case of Aseptic Temporomandibular Joint Abscess Associated with Inflammatory Bowel Disease

Inflammatory bowel diseases are characterized by diverse extraintestinal manifestations, including arthritis and eruption. However, there are no previous reports in the literature of cases with temporomandibular joint abscess as an extraintestinal manifestation of inflammatory bowel disease. We report an extremely rare case of temporomandibular joint abscess diagnosed as an extraintestinal manifestation of inflammatory bowel disease. The patient was a 20 ― year ― old man who presented to us with a 3 ― week history of symptoms of multiarthritis, including acute trismus caused by involvement of the left temporomandibular joint. He underwent emergency hospitalization at our institution with a diagnosis of left temporomandibular joint abscess. The arthritis with trismus and high fever did not improve despite antibiotic treatment, and subsequently, the patient developed anemia, eruption, and bloody stools in addiion. Colonoscopy was performed, and the bloody stool was diagnosed as a symptom of inflammatory bowel disease. Because all the symptoms, including trismus, improved dramatically immediately after the initiation of prednisolone to treat the inflammatory bowel disease, we also considered the temporomandibular joint abscess in this case as an extraintestinal manifestation. In patients presenting with arthritis symptoms of unknown origin in the head and neck region, inflammatory bowel disease should be included in the differential diagnosis. To obtain an early diagnosis, it is important to be alert to the presence/development of anemia and gastrointestinal symptoms.