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Case Reports
. 2020 Apr 21;20(1):295.
doi: 10.1186/s12879-020-05015-5.

Odontogenic cutaneous sinus tracts due to infection with nontuberculous mycobacteria: a report of three cases

Ricardo Pérez-Alfonzo  1 , Luisa Elena Poleo Brito  2 , Marialejandra Solano Vergara  2 , Angela Ruiz Damasco  2 , Perla Luiguimar Meneses Rodríguez  2 , Carmen Elena Kannee Quintero  1 , Carolina Carrera Martinez  1 , Ismar Alejandra Rivera-Oliver  3   4 , Omaira J Da Mata Jardin  3 , Bárbara A Rodríguez-Castillo  3 , Jacobus H de Waard  5   6
Affiliations
Case Reports

Odontogenic cutaneous sinus tracts due to infection with nontuberculous mycobacteria: a report of three cases

Ricardo Pérez-Alfonzo et al. BMC Infect Dis. .

Abstract

Background: Soft tissue or skin infections due to nontuberculous mycobacteria (NTM) have been reported frequently and are mostly associated with trauma or cosmetic interventions like plastic surgery. However, infection with NTM as a result of a dental procedure have rarely been described and the lack of clinical suspicion and a clear clinical manifestation makes diagnosis challenging.

Case presentation: We report on three patients with a facial cutaneous sinus tract of dental origin, due to an infection with respectively Mycobacterium fortuitum, M. abscessus and M. peregrinum. The infection source was the dental unit waterlines (DUWLs), which were colonized with NTM.

Conclusions: Water of the DUWL can pose a health risk. This report emphasizes the need for quality control and certification of water flowing through DUWLs, including the absence of NTM. Our report also shows the need for a rapid recognition of NTM infections and accurate laboratory diagnosis in order to avoid long-term ineffective antibiotic treatment.

Keywords: Cutaneous sinus tract; Dental unit waterline (DUWL); Mycobacterium abscessus; Mycobacterium fortuitum; Mycobacterium peregrinum; Nontuberculous mycobacteria (NTM); Soft tissue infection.

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Conflict of interest statement

The authors declare that they have no competing interests regarding the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
a-e The three patients from Caracas, Venezuela visiting our clinic for a diagnosis. a and b Patient 1 and patient 2 with the diagnosis of a dental sinus tract caused by respectively a M. fortuitum and M. abscessus infection. c and d Patient 3 with an infection due to M. peregrinum. Shown are the cutaneous facial sinus tract and an affected lymph node draining in the neck. The affected lymph node in the neck was removed with surgery. e A panoramic radiography of the patient 3 showing a radiolucent lesion of the periapical area of a mandibular molar (white arrow)
See this image and copyright information in PMC

References

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