Nasal sinus tract associated with odontogenic infection: A case report of misdiagnosis and treatment delay

Odontogenic infections with extraoral sinus tract drainage are frequently misdiagnosed, particularly when they present in atypical locations such as the nasal cavity. This case report describes a 38-year-old female who experienced persistent malodor and purulent discharge from her left nostril for 2 years. She was misdiagnosed with pustular and cystic acne and received prolonged, ineffective dermatological treatments. The condition remained unresolved until an incidental radiographic finding prompted a referral to an endodontist. A diagnosis of an odontogenic sinus tract secondary to pulp necrosis in tooth #21 was established. Nonsurgical root canal therapy led to complete symptom resolution. This case highlights the diagnostic challenge posed by atypical presentations of odontogenic infections and emphasizes the importance of multidisciplinary collaboration in improving patient outcomes.