Odontogenic Cutaneous Fistula in Pregnant Woman: Is Long-Term Antibiotic Therapy the Solution?

TL;DR

A pregnant woman developed a dental-related skin infection that required careful antibiotic treatment to protect both her and her baby.

Contribution

This case highlights the management challenges of odontogenic infections during pregnancy and the need for tailored antibiotic therapy.

Findings

The infection was initially misdiagnosed as a furuncle and treated with amoxicillin.

Switching to clarithromycin after infection progression led to gradual resolution over five months.

The pregnancy had no complications, and the baby was born healthy.

Abstract

A 30-year-old pregnant woman developed an odontogenic cutaneous fistula (OCF) five months after having her wisdom tooth extracted. Initially diagnosed as a cutaneous furuncle, the condition was treated with amoxicillin, resulting in temporary improvement. However, it recurred after a month. Upon further evaluation, the lesion was diagnosed as an OCF originating from a chronic dental infection. Due to the patient’s pregnancy, the treatment focused on non-invasive periodontal care, including scaling, while antibiotic therapy was maintained. Amoxicillin was initially prescribed; however, due to the progression of the infection, the treatment was switched to clarithromycin after consultation with a dermatologist. Over five months, the lesion gradually resolved, with no acute symptoms remaining. The pregnancy progressed without complications, and the patient gave birth to a healthy baby. This case underscores the challenges of managing odontogenic infections during pregnancy and highlights the importance of tailored antibiotic therapy to ensure the safety of both the mother and fetus.

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