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牙周炎患者的肺部感染伪装为恶性肿瘤。

Pulmonary infection masquerades as malignancy in a patient with periodontitis.

机构信息

Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia.

Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia

出版信息

BMJ Case Rep. 2021 Feb 1;14(2):e239636. doi: 10.1136/bcr-2020-239636.

Abstract

A 49-year-old man with a 37.5 pack-year smoking history presented with a suspected neoplasm of the right lung following the discovery of a metabolically active mass on positron emission tomography-CT imaging. The patient, who demonstrated poor oral hygiene, had a history of irregular problem-oriented dental visitation. Having excluded malignancy through histologic investigations, -a well-established periodontal pathogen-was subsequently cultured from his pulmonary aspirate. The patient was therefore managed with systemic antimicrobials and adjunctive dental extractions to eliminate the likely source of infection, whereafter the mass resolved without complication. This case corroborates previous reports of extraoral isolation of , which may mimic cancer clinically and radiographically. While a definitive causative link between untreated periodontitis and systemic infection remains to be elucidated, such cases present a compelling argument in favour of promoting oral health to prevent systemic disease.

摘要

一位 49 岁的男性,有 37.5 包年的吸烟史,在正电子发射断层扫描 - CT 成像上发现代谢活跃的肿块后,被怀疑患有右肺癌。这位患者口腔卫生状况不佳,有不定期接受问题导向牙科治疗的病史。通过组织学检查排除了恶性肿瘤后,从他的肺抽吸物中培养出了一种已确立的牙周病原体。因此,患者接受了全身抗菌药物治疗和辅助性拔牙,以消除可能的感染源,此后肿块无并发症消退。该病例证实了先前关于 口腔外分离的报道, 这种病原体在临床上和影像学上可能与癌症相似。虽然牙周炎未经治疗与全身感染之间的明确因果关系仍有待阐明,但这些病例有力地证明了促进口腔健康以预防全身疾病的重要性。

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