Fever accompanied by mandibular pain and swelling is most commonly associated with odontogenic infections, facial cellulitis, or Parotid Tumors. We report the case of a 46-year-old woman who pre-sented with a three-week history of persistent right facial swelling, right mandibular pain, and gingival swelling. She was initially evaluated at an otolaryngology outpatient clinic; however, her symptoms failed to improve. Subsequently, she developed fever and generalized bone pain and sought treatment at the emergency department. Based on the initial clinical presentation, right facial cellulitis was sus-pected, and the patient was admitted for further evaluation and treatment. Radiographic examination of the mandible and computed tomography (CT) of the oral cavity revealed multiple osteolytic lesions involving the right mandible and left maxilla. Because of persistent fever, further chest and abdominal CT examinations were performed and identified additional osteolytic lesions in the iliac bones. His-topathological analysis of an iliac bone biopsy ultimately confirmed the diagnosis of Langerhans cell histiocytosis (LCH). Following systemic chemotherapy, the patient’s symptoms gradually improved, and a favorable therapeutic outcome was achieved. LCH is a rare disorder that occurs predominantly in children and is relatively uncommon in adults. Owing to its nonspecific clinical manifestations, diagnosis may be delayed or overlooked. This case highlights the importance of including LCH in the differential diagnosis of adult patients presenting with persistent fever, mandibular pain or swelling, and unexplained osteolytic bone lesions. Early recognition, comprehensive diagnostic evaluation, and timely histopathological confirmation are essential for appropriate treatment and improved patient outcomes.
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