Annachiara Ghiotti, Jacopo Monticelli, Marina Busetti, Michele Maglione, Stefano Di Bella, Fabio Barbone, Raffaella Koncan
Odontogenic abscesses are characteristically polymicrobial infections where fastidious anaerobes play a critical role. Conventional culture methods often fail to identify these pathogens, leading to diagnostic and therapeutic challenges. We present a case of a severe deep neck and metastatic lung abscess following third molar extraction. While the initial culture of the abscess drainage was deceiving, 16S rRNA sequencing revealed the infection's real anaerobic nature. Therapy was successfully targeted, leading to full clinical resolution. This case highlights the limitations of culture methods and the importance of molecular diagnosis in guiding optimal management of complicated odontogenic infections.