# Mycobacterium fortuitum Infection Mimicking an Odontogenic Abscess: Report of a Pediatric Case with Relevant Literature Analysis

## TL;DR

A 6-year-old girl's sub-mandibular swelling caused by Mycobacterium fortuitum was mistaken for a dental abscess, highlighting the rare occurrence of NTM infections in this context.

## Contribution

This paper reports a rare pediatric case of Mycobacterium fortuitum infection mimicking an odontogenic abscess.

## Key findings

- Mycobacterium fortuitum was identified as the causative agent through fine-needle aspiration and microbiologic testing.
- The patient fully recovered after 8 months of medical and surgical treatment.
- The case emphasizes the need for careful differential diagnosis of sub-mandibular swellings in children.

## Abstract

Non-tuberculous mycobacteria (NTM) are saprophytes of both soil and water that may cause infection with a high risk of dissemination, mainly in immunocompromised patients. Most NTM infections occur in the lungs, while uncommon localizations are the skin, soft tissues, musculoskeletal apparatus, and lymphatic system. The possible relationship between NTM infections and dental procedures is still unclear. The authors reported a rare manifestation of NTM infection occurring in a 6-year-old girl who developed sub-mandibular swelling related to a necrotic tooth, thus mimicking an abscess of odontogenic origin. Fine-needle aspiration biopsy of the sub-mandibular swelling and the following microbiologic investigation showed infection sustained by the Mycobacterium fortuitum complex. After the medical and surgical treatment, the patient completely recovered after 8 months. A review of the relevant literature was carried out to deepen the clinical and microbiological aspects of such a rare occurrence.