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牙科感染引起的脓毒性肺栓塞。

Septic pulmonary embolism induced by dental infection.

作者信息

Shiota Yutaro, Taniguchi Akihiko, Yuzurio Syota, Horita Naokatsu, Hosokawa Shinobu, Watanabe Yoichi, Tohmori Hidetoshi, Ono Tetsuya

机构信息

Department of Respiratory Diseases, Kure Kyosai Hospital, Kure, Hiroshima 737-8505, Japan.

出版信息

Acta Med Okayama. 2013;67(4):253-8. doi: 10.18926/AMO/51070.

Abstract

Dental infection can be an important source for septic pulmonary embolism (SPE), but only a few cases of SPE accompanying dental infection have been reported. The aim of this study was to characterize the clinical features of SPE induced by dental infection. Patients who fulfilled the diagnostic criteria described in the text were recruited in a retrospective fashion. All 9 patients were men, with a median age of 59 years (range:47 to 74 years). Eight patients had chest pain (88.9%), 5 had a preceding toothache (55.6%) and 3 had preceding gingival swelling (33.3%). Blood cultures obtained from 7 patients were negative. Periodontitis was found in all of the cases, periapical periodontitis in 5 cases, and gingival abscess in 3 cases. The median duration of hospitalization was 15 days, and symptoms were mild in some cases. In addition to antimicrobial therapy, tooth extraction was performed in 3 cases, tooth scaling in 6. SPE induced by dental infection has prominent clinical characteristics such as male preponderance, chest pain, preceding toothache, and mild clinical course.

摘要

牙科感染可能是脓毒性肺栓塞(SPE)的一个重要来源,但仅有少数伴有牙科感染的SPE病例被报道。本研究的目的是描述由牙科感染诱发的SPE的临床特征。符合文中所述诊断标准的患者以回顾性方式纳入研究。所有9例患者均为男性,中位年龄59岁(范围:47至74岁)。8例患者有胸痛(88.9%),5例有先前牙痛史(55.6%),3例有先前牙龈肿胀史(33.3%)。7例患者的血培养结果为阴性。所有病例均发现有牙周炎,5例有根尖周炎,3例有牙龈脓肿。中位住院时间为15天,部分病例症状较轻。除抗菌治疗外,3例患者接受了拔牙,6例接受了洗牙。由牙科感染诱发的SPE具有男性居多、胸痛、先前牙痛及临床过程较轻等突出临床特征。

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