Respiratory Disease Center, the Tazuke Kofukai Medical Research Institute, Kitano Hospital, Ohgimachi, Kita-ku, Osaka, Japan.
Respirology. 2013 Feb;18(2):308-12. doi: 10.1111/j.1440-1843.2012.02278.x.
Septic pulmonary embolism due to periodontal disease (SPE-PD) is rarely reported and little is known about its clinical features. The purpose of this study was to evaluate the clinical and radiological features, as well as outcome, in SPE-PD.
Patients' records were retrospectively reviewed and 12 patients with SPE-PD were identified (10 men, mean age 60.5 years). The patients' demographic features, laboratory data, physical and radiological findings, and clinical outcomes were evaluated.
All but one patient were smokers. Eight of the 12 patients had comorbidities including hypertension (58%) and/or diabetes mellitus (17%). Prevalent symptoms were fever (67%) and chest pain (58%). Only two patients fulfilled the criteria of systemic inflammatory response syndrome; most of the subjects were not clinically severely ill. Blood cultures were negative in all cases. Contrast-enhanced chest computed tomography (CT) showed multiple peripheral nodules in all 12 patients, wedge-shaped peripheral lesions abutting on the pleura in 10 (83%) and a feeding-vessel sign in 9 (75%). All patients recovered from their illness after antimicrobial therapy concomitant with tooth extraction or periodontal care. The median duration of antibiotic administration was 51 days.
Most patients with SPE-PD were not seriously ill. Contrast-enhanced chest CT appeared to be useful to diagnose SPE-PD.
牙周病引起的脓毒性肺栓塞（SPE-PD）很少见，其临床特征鲜为人知。本研究旨在评估 SPE-PD 的临床和影像学特征及转归。
回顾性分析患者病历，共确诊 12 例 SPE-PD 患者（男 10 例，平均年龄 60.5 岁）。评估患者的人口统计学特征、实验室数据、体格检查和影像学发现及临床转归。
除 1 例患者外，其余患者均为吸烟者。12 例患者中有 8 例合并有高血压（58%）和/或糖尿病（17%）等疾病。常见症状为发热（67%）和胸痛（58%）。仅有 2 例患者符合全身炎症反应综合征标准；大多数患者病情未达临床危重型。所有患者血培养均为阴性。12 例患者均行增强胸部 CT 检查，均显示多发外周结节，10 例（83%）有楔形外周病变贴邻胸膜，9 例（75%）有滋养血管征。所有患者经抗菌治疗联合拔牙或牙周护理后均痊愈。抗菌药物的中位使用时间为 51 天。
大多数 SPE-PD 患者病情不重。增强胸部 CT 有助于诊断 SPE-PD。
