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源自牙脓肿的链状艾氏菌感染可导致严重的肠道并发症和颌骨骨髓炎。

Eggerthia catenaformis infection originating from a dental abscess causes severe intestinal complications and osteomyelitis of the jaw.

作者信息

Sakkas Andreas, Nolte Isabel, Heil Sebastian, Mayer Boris, Kargus Steffen, Mischkowski Robert A, Thiele Oliver C

机构信息

Department of Oral, Maxillofacial and Facial Plastic Surgery, Ludwigshafen Hospital, Ludwigshafen, Germany.

出版信息

GMS Interdiscip Plast Reconstr Surg DGPW. 2021 Apr 14;10:Doc02. doi: 10.3205/iprs000152. eCollection 2021.

Abstract

Odontogenic foci may result to generalized infections spreading the bacteria through contiguous anatomic cavities or hematogenous spread. The most reported secondary infections caused by oral pathogens are intracranial abscesses. Although, few reports in the literature describe the bacterial spread to extracranial locations. We describe the case of a 52-year-old male Caucasian patient who was admitted to our hospital suffering from severe sepsis caused by a submandibular abscess. was detected in blood and abscess material (confirmed by MALDI-TOF mass spectrometry). The patient subsequently developed a perihepatic abscess and colon perforation, and was stabilized after several surgical interventions. He remained hospitalized for 66 days receiving intravenous antibiotics. Five months later, jaw osteonecrosis with Actinomyces contamination was detected in the left mandible, which also had to be treated surgically. Three years after the last surgery, no signs of recurrence have been detected. Oral and maxillofacial surgeons should understand the characteristics of systemic infections, in which the potentially causal intraoral odontogenic foci often lack acute symptoms. If other origins of infection are not detected, elimination of the potentially causal odontogenic foci should be performed. However, the decision making criteria to eliminate suspected causal teeth is needed to be elucidated through more studies.

摘要

牙源性病灶可能导致全身性感染,细菌通过相邻的解剖腔隙扩散或经血行播散。口腔病原体引起的最常见继发性感染是颅内脓肿。尽管文献中很少有报道描述细菌扩散至颅外部位。我们描述了一例52岁的男性白种人患者,因下颌下脓肿导致严重脓毒症入住我院。在血液和脓肿材料中检测到(通过基质辅助激光解吸电离飞行时间质谱法确认)。患者随后出现肝周脓肿和结肠穿孔,经过多次手术干预后病情稳定。他住院66天,接受静脉抗生素治疗。五个月后,在左下颌骨检测到放线菌污染的颌骨骨髓炎,也必须进行手术治疗。最后一次手术后三年,未检测到复发迹象。口腔颌面外科医生应了解全身感染的特点,其中潜在的口腔牙源性病灶往往缺乏急性症状。如果未检测到其他感染源,应消除潜在的牙源性病灶。然而,需要通过更多研究来阐明消除可疑致病牙的决策标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b892/8051610/8fdfb7f9455b/IPRS-10-02-g-001.jpg

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