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孕妇牙源性皮肤瘘管:长期抗生素治疗是解决办法吗?

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

作者信息

Imura Hideto, Nguyen Chi K, Niimi Teruyuki, Miwa Ryosuke, Natsume Nagato

机构信息

Cleft Lip and Palate Center, Aichi Gakuin University, Nagoya, JPN.

Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, JPN.

出版信息

Cureus. 2025 Apr 24;17(4):e82948. doi: 10.7759/cureus.82948. eCollection 2025 Apr.

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.

摘要

一名30岁孕妇在拔除智齿五个月后出现牙源性皮肤瘘管(OCF)。最初被诊断为皮肤疖肿,使用阿莫西林治疗后病情暂时好转。然而,一个月后复发。进一步评估后,该病变被诊断为源自慢性牙齿感染的牙源性皮肤瘘管。由于患者怀孕,治疗重点为非侵入性牙周护理,包括洗牙,同时维持抗生素治疗。最初开具的是阿莫西林;然而,由于感染进展,经与皮肤科医生会诊后,治疗改为克拉霉素。五个多月来,病变逐渐消退,无急性症状残留。妊娠进展顺利,未出现并发症,患者生下一个健康的婴儿。该病例强调了孕期管理牙源性感染的挑战,并突出了定制抗生素治疗以确保母婴安全的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0fc/12103648/369a89cb5149/cureus-0017-00000082948-i01.jpg

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