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

• Published in: BMC infectious diseases Vol. 20; no. 1; p. 295
• Main Authors: Pérez-Alfonzo, Ricardo, Poleo Brito, Luisa Elena, Vergara, Marialejandra Solano, Ruiz Damasco, Angela, Meneses Rodríguez, Perla Luiguimar, Kannee Quintero, Carmen Elena, Carrera Martinez, Carolina, Rivera-Oliver, Ismar Alejandra, Da Mata Jardin, Omaira J, Rodríguez-Castillo, Bárbara A, de Waard, Jacobus H
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21.04.2020; BioMed Central; BMC
• Subjects: Antibiotics; Case Report; Cutaneous sinus tract; Dentists; Diagnosis; Disinfection & disinfectants; Drinking water; Fistula; Fungi; Health aspects; Health risks; Infection; Infections; Infectious diseases; Laboratories; Lymphatic system; Mycobacterium abscessus; Mycobacterium fortuitum; Mycobacterium peregrinum; Nontuberculous mycobacteria (NTM); Oxacillin; Patients; Plastic surgery; Quality control; Sinuses; Skin; Soft tissue infection; Soft tissues; Surgery; Trauma; Venezuela; Cutaneous sinus tract; Mycobacterium peregrinum; Soft tissue infection; Mycobacterium fortuitum; Dental unit waterline (DUWL); Mycobacterium abscessus; Nontuberculous mycobacteria (NTM)
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-020-05015-5

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. 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. 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.