Pediatric Dental Clinic-Associated Outbreak of Mycobacterium abscessus Infection

被引：35

作者：

Hatzenbuehler, Lindsay A. ^{[1
,2
,3
]}

Tobin-D'Angelo, Melissa ^{[4
]}

Drenzek, Cherie ^{[4
]}

Peralta, Gianna ^{[4
]}

Cranmer, Lisa C. ^{[1
,2
,5
,6
]}

Anderson, Evan J. ^{[1
,2
,5
,6
,7
,8
]}

Milla, Sarah S. ^{[5
,6
,9
]}

Abramowicz, Shelly ^{[5
,6
,10
]}

Yi, Jumi ^{[1
,2
,5
,6
]}

Hilinski, Joseph ^{[2
,11
]}

Rajan, Roy ^{[5
,6
,12
]}

Whitley, Matthew K. ^{[6
,13
]}

Gower, Verlia ^{[6
,13
]}

Berkowitz, Frank ^{[1
,2
,5
,6
]}

Shapiro, Craig A. ^{[1
,2
,5
,6
]}

Williams, Joseph K. ^{[6
,14
]}

Harmon, Paula ^{[6
,13
]}

Shane, Andi L. ^{[1
,2
,5
,6
]}

机构：

[1] Baylor Coll Med, Div Pediat Infect Dis, 1102 Bates St Suite 1150, Houston, TX 77030 USA

[2] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA

[3] Baylor Coll Med, Houston, TX 77030 USA

[4] Georgia Dept Publ Hlth, Atlanta, GA USA

[5] Emory Sch Med, Atlanta, GA USA

[6] Childrens Healthcare Atlanta, Atlanta, GA USA

[7] St Lukes Childrens Hosp, Div Infect Dis, Boise, ID USA

[8] St Lukes Childrens Hosp, Dept Med, Boise, ID USA

[9] St Lukes Childrens Hosp, Dept Pediat Radiol, Boise, ID USA

[10] St Lukes Childrens Hosp, Dept Pediat Oral & Maxillofacial Surg, Boise, ID USA

[11] St Lukes Childrens Hosp, Boise, ID USA

[12] Dept Pediat Otolaryngol Head & Neck Surg, Boise, ID USA

[13] Pediat Ear Nose & Throat Atlanta, Boise, ID USA

[14] Dept Pediat Plast & Reconstruct Surg, Boise, ID USA

来源：

JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY | 2017年 / 6卷 / 03期

关键词：

Mycobacterium abscessus; pediatric dental infections; pediatric odontogenic infections; CERVICOFACIAL LYMPHADENITIS; NONTUBERCULOUS MYCOBACTERIA; CHILDREN; MANAGEMENT; ABDOMINOPLASTY; CHELONAE;

D O I：

10.1093/jpids/pix065

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background. Mycobacterium abscessus is an uncommon cause of invasive odontogenic infection. Methods. M abscessus-associated odontogenic infections occurred in a group of children after they each underwent a pulpotomy. A probable case-child was defined as a child with facial or neck swelling and biopsy-confirmed granulomatous inflammation after a pulpotomy between October 1, 2013, and September 30, 2015. M abscessus was isolated by culture in confirmed case-children. Clinical presentation, management, and outcomes were determined by medical record abstraction. Results. Among 24 children, 14 (58%) were confirmed case-children. Their median age was 7.3 years (interquartile range, 5.8-8.2 years), and the median time from pulpotomy to symptom onset was 74 days (range, 14-262 days). Clinical diagnoses included cervical lymphadenitis (24 [100%] of 24), mandibular or maxillary osteomyelitis (11 [48%] of 23), and pulmonary nodules (7 [37%] of 19). Each child had >= 1 hospitalization and a median of 2 surgeries (range, 1-6). Of the 24 children, 12 (50%) had surgery alone and 11 (46%) received intravenous (IV) antibiotics. Nineteen of the 24 (79%) children experienced complications, including vascular access malfunction (7 [64%] of 11), high-frequency hearing loss (5 [56%] of 9), permanent tooth loss (11 [48%] of 23), facial nerve palsy (7 [29%] of 24), urticarial rash (3 [25%] of 12), elevated liver enzyme levels (1 [20%] of 5), acute kidney injury (2 [18%] of 11), incision dehiscence/fibrosis (3 [13%] of 24), and neutropenia (1 [9%] of 11). Conclusions. M abscessus infection was associated with significant medical morbidity and treatment complications. Unique manifestations included extranodal mandibular or maxillary osteomyelitis and pulmonary nodules. Challenges in the identification of case-children resulted from an extended incubation period and various clinical manifestations. Clinicians should consider the association between M abscessus infection and pulpotomy in children who present with subacute cervical lymphadenitis. The use of treated/sterile water during pulpotomy might prevent further outbreaks.

引用

页码：E116 / E122

页数：7