Hedström S A, Nord C E, Ursing B
Scand J Infect Dis. 1980;12(2):117-21. doi: 10.3109/inf.1980.12.issue-2.08.
4 patients with a history of initial fever 2--4 weeks passing on to fever peaks every 3rd to 6th day with afebrile intervals repeating for months are presented. Three of them had dental infectious foci mainly in maxillar teeth and 1 patient was treated by a dentist 1 month before onset. None showed meningism or clinical signs of encephalitis. Extensive investigations resulted only in findings from the central nervous system. The EEG was slightly pathological in all cases and papilloedema was found in 2 cases. In the cerebrospinal fluid (CSF) a pleocytosis extending over months, transient presence of plasma cells and increased proteins in the gamma region on agar electrophoresis was found. In 1 case antigen from Streptococcus milleri, a commensal of the mouth flora at times isolated from infectious dental foci, was detected in CSF by counterimmunoelectrophoresis 6 weeks after onset of the disease. Treatment with penicillin had no effect on the fever. Three patients received antiphlogistic drugs with benefit and their dental foci were treated by a dentist.
报告了4例患者，他们最初发热2至4周，随后每3至6天出现发热高峰，无热期持续数月。其中3例有牙齿感染灶，主要在上颌牙齿，1例患者在发病前1个月由牙医治疗过。均未出现脑膜刺激征或脑炎的临床体征。广泛检查仅发现中枢神经系统有异常。所有病例脑电图均有轻度病理改变，2例发现视乳头水肿。脑脊液中发现细胞增多持续数月，浆细胞短暂出现，琼脂电泳显示γ区蛋白质增加。1例患者在疾病发作6周后，通过对流免疫电泳在脑脊液中检测到米勒链球菌抗原，该菌是口腔菌群的共生菌，有时从感染性牙灶中分离出来。青霉素治疗对发热无效。3例患者接受抗炎药物治疗后病情好转，其牙齿病灶由牙医进行了治疗。
