Deep Neck Cellulitis, Myositis, and Reactive Lymphadenitis Secondary to Rothia dentocariosa in an Immunocompetent Female: A Case Report

TL;DR

A rare case of severe neck infection caused by Rothia dentocariosa in a healthy woman is reported, highlighting its potential virulence.

Contribution

This case report documents an unusual infection caused by R. dentocariosa in an immunocompetent individual.

Findings

Rothia dentocariosa caused deep neck cellulitis, myositis, and reactive lymphadenitis in an immunocompetent patient.

The patient recovered fully after appropriate antibiotic treatment.

The case suggests that R. dentocariosa may have higher virulence potential than previously assumed.

Abstract

Rothia dentocariosa is a commensal organism that is typically found in the oropharyngeal and respiratory tracts, and it typically possesses a low virulence profile, especially for immunocompetent patients. The case presented here represents an extremely rare case of deep neck cellulitis, myositis, and reactive lymphadenitis secondary to R. dentocariosa in an immunocompetent female. A 35-year-old female with no significant past medical history presented to the emergency department with neck pain with reduced range of motion, fever, chills, sinus congestion, and headache for one day. After a thorough workup, blood cultures grew R. dentocariosa in the days following admission. The patient subsequently recovered without any notable sequelae after proper antibiotic treatment. Since Rothia species are currently considered a low-virulence organism that typically causes endocarditis in immunocompromised hosts, this case should serve as a reference for its possible virulence level in immunocompetent hosts. In spite of this organism's pathological rarity, this case highlights the importance of understanding the microbiology, historical context, and treatment for R. dentocariosa as a cause for deep neck cellulitis, myositis, and reactive lymphadenitis.

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