Department of Rheumatology, Chubu Rosai Hospital, 2-10-15, Komei-cho, Minato-ku, Nagoya, Aichi, 468-0008, Japan.
Department of Rheumatology, Chubu Rosai Hospital, 1-10-6, Komei-cho, Minato-ku, Nagoya, 455-8530, Japan.
BMC Infect Dis. 2019 Jan 21;19(1):74. doi: 10.1186/s12879-019-3710-3.
Periodontal disease, including periodontitis, has been reported to be a rare cause of septic pulmonary embolism (SPE). It is however extremely difficult to isolate the causative pathogen of periodontal disease-associated SPE from blood cultures of these patients.
In this study, an 85-year-old Japanese man was admitted with fever and worsening malaise. He was later noted to have multiple bilateral subpleural pulmonary nodules on chest computed tomography scan. After admission, Parvimonas micra (P. micra) was isolated from his blood culture. This was followed by a meticulous search for the primary source of SPE, focusing on the head and neck areas. Consequently, apical periodontitis and infratemporal fossa abscess were identified as the primary sources of SPE. Although P. micra is one of the most frequently detected bacteria in the infected root canals of teeth with chronic apical periodontitis, it has rarely been proven as a causative pathogen of periodontal disease-associated SPE.
This case study demonstrated that periodontal disease is an important primary source of SPE and P. micra could be a causative pathogen of SPE.
牙周病，包括牙周炎，已被报道为罕见的败血性肺栓塞（SPE）的病因。然而，从这些患者的血液培养中分离出牙周病相关 SPE 的致病病原体极其困难。
在这项研究中，一名 85 岁的日本男性因发热和恶化的不适而入院。后来，胸部计算机断层扫描发现他有多发性双侧胸膜下肺结节。入院后，从他的血液培养中分离出微小 Parvimonas（P. micra）。随后，仔细寻找 SPE 的主要来源，重点关注头部和颈部区域。因此，根尖周炎和颞下窝脓肿被确定为 SPE 的主要来源。虽然 P. micra 是慢性根尖周炎感染根管中最常检测到的细菌之一，但它很少被证明是牙周病相关 SPE 的致病病原体。
本病例研究表明，牙周病是 SPE 的重要原发性病因，P. micra 可能是 SPE 的致病病原体。
