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Odontogenic Infections with Cutaneous Involvement in Children: a Case Series Joana Monteiro Adèle Johnson Pathanjali Kandiah Prabhleen Anand Stephen Fayle Dental Update 2024 47:2, 707-709.
Cutaneous involvement of dental sepsis is a rare occurrence in children. It often presents as a diagnostic dilemma, especially in the absence of oral symptoms, with initial presentation to non-dental professionals. This article discusses three cases of children presenting with cutaneous involvement of odontogenic origin to two paediatric dentistry departments in the UK. All cases had delayed presentations and were initially submitted to ineffective treatment, with significant impact on the children’s well-being. Final management included antibiotic therapy, drainage and extraction of the septic tooth.
These three cases highlight the importance of considering a dental aetiology for localized inflammatory and purulent skin lesions of the mandible. Prompt diagnosis and early treatment are determinant for early resolution and avoidance of systemic or psychological complications.
CPD/Clinical Relevance: This article discusses diagnosis and management of three different presentations of odontogenic sepsis with cutaneous involvement in children.
Article
Odontogenic infections with cutaneous involvement are well described in dental and medical literatures. Although dental caries has slowly declined over the last decade, it remains the most prevalent disease of childhood, affecting 24.7% of 5-year-olds in England. Coupled with this, the prevalence of sepsis of dental origin has also reduced in this age group (2.3% in 2007/08 to 1.4% in 2015).1,2 Cutaneous involvement of dental sepsis is, therefore, a relatively rare occurrence in children. This adds to the diagnostic dilemma, often complicated by initial presentation to non-dental professionals. Misdiagnosis may lead to a number of unnecessary therapies directed at non-odontogenic aetiologies.3 This article reports three different presentations of odontogenic infections with cutaneous manifestations in children, where correct diagnosis and multidisciplinary care were key to successful outcomes.
Odontogenic infections with cutaneous involvement may present as relatively well localized inflammatory skin lesions, often with purulent collections and discharge. Differential diagnosis may include osteomyelitis, actinomycosis, foreign body, local skin infection, pyogenic granuloma, salivary gland and duct fistulae, cat scratch disease, toxoplasmosis, suppurative lymphadenitis, neoplasm and tuberculosis.3,4 It is imperative to take a good medical history in order to rule out systemic involvement and aetiology.
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