Septic pulmonary embolism due to periodontal disease

Hatani, Takeshi; Takemura, Masashi; Inoue, Daiki; Takamatsu, Kazufumi; Ishitoko, Manabu; Itotani, Ryo; Suzuki, Shinichi; Matsumoto, Masataka; Sakuramoto, Minoru; Fukui, Motonari

doi:10.1111/j.1440-1843.2012.02278.x

Cited by 13 publications

(15 citation statements)

References 11 publications

(20 reference statements)

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“…In the 2000s, Cook et al reported that Lemierre syndrome and central venous catheter infection were the common causes of SPE [3]. Moreover, two studies from Taiwan and one from Japan reported on SPE cases caused by liver abscesses [16, 17] and periodontal disease [7], respectively. Recently, several studies demonstrated that bone, skin, and soft tissue infections are the most common source of infection [4, 6, 14].…”

Section: Discussionmentioning

confidence: 99%

“…Septic pulmonary embolism (SPE), unlike the much more common thrombotic pulmonary embolism, is a rare disorder in which a bacterial embolus containing microorganisms originating from the primary extrapulmonary infectious foci [1] (such as liver abscesses [2], peritonsillar abscesses [3], infection of skin and bone [4], infective endocarditis [5, 6], periodontal disease [7], intravascular devices and catheters [3]) obstructs the small pulmonary vasculature, causing sepsis and a focal abscess in the lung. SPE is associated with a high mortality rate and remains a diagnostic challenge in clinical practice due to its insidious onset, nonspecific clinical manifestations (such as fever, cough, dyspnea, chest pain and hemoptysis), and life-threatening complications [8].…”

Section: Introductionmentioning

confidence: 99%

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Septic pulmonary embolism in China: clinical features and analysis of prognostic factors for mortality in 98 cases

et al. 2019

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BackgroundTo investigate the clinical features of septic pulmonary embolism (SPE) cases and prognostic factors for in-hospital mortality in China.MethodsA retrospective analysis was conducted of SPE patients hospitalized between January 2007 and June 2018 in the Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University.ResultsA total of 98 patients with SPE were identified. All patients had bilateral multiple peripheral nodules on chest computed tomography. The most common pathogen found in blood culture was Staphylococcus aureus (10/33, 30.3%). Transthoracic echocardiography was performed in 39 patients and 20 showed vegetations. Bronchoscopy was performed in 24 patients. Bronchoalveolar lavage fluid (BALF) was obtained from 15 patients (62.5%) and showed predominantly polymorphonuclear cell infiltration (52%, range of 48%~ 63%). Four patients received transbronchial lung biopsy, and histopathological examinations revealed suppurative pneumonia and organizing pneumonia. The in-hospital mortality rate was 19.4%. Age (odds ratio [OR] 1.100; 95% confidence interval [CI] 1.035–1.169), hypotension (OR 7.260; 95% CI 1.126–46.804) and ineffective or delay of empirical antimicrobial therapy (OR 7.341; 95% CI 1.145–47.045) were found to be independent risk factors for in-hospital mortality, whereas drainage treatment was found to be a protective factor (OR 0.33; 95% CI 0.002–0.677).ConclusionsSPE cases presented with nonspecific clinical manifestations and radiologic features. Blood cultures and bronchoscopy are important measures for early diagnosis and differential diagnosis. There is relationship between primary infection sites and the type of pathogen. Maintaining normal blood pressure and providing timely and appropriate initial antimicrobial therapy for effective control of the infection could improve prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Septic pulmonary embolism in China: clinical features and analysis of prognostic factors for mortality in 98 cases

et al. 2019

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“…Articles published from January 1, 1980 to September 1, 2018 were included. A literature review disclosed thirty-seven previously reported cases of periodontal disease-associated SPE including the present case (Table 1) [2, 3, 5–18]. The case definition for periodontal disease-associated SPE included: (A) focal or multifocal lung filtrates compatible with septic embolism to the lung, (B) presence of periodontal disease, and (C) absence of other active extrapulmonary infection as a potential cause of SPE, which were confirmed for each case of previously reported periodontal disease-associated SPE.…”

Section: Discussionmentioning

confidence: 99%

“…The case definition for periodontal disease-associated SPE included: (A) focal or multifocal lung filtrates compatible with septic embolism to the lung, (B) presence of periodontal disease, and (C) absence of other active extrapulmonary infection as a potential cause of SPE, which were confirmed for each case of previously reported periodontal disease-associated SPE. The definition was a slightly modified version of those reported by Cook et al [4] and Hatani et al [5].…”

Section: Discussionmentioning

confidence: 99%

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Septic pulmonary embolism associated with periodontal disease: a case report and literature review

2019

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BackgroundPeriodontal 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.Case presentationIn 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.ConclusionsThis case study demonstrated that periodontal disease is an important primary source of SPE and P. micra could be a causative pathogen of SPE.

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Risk factors for mortality in patients with septic pulmonary embolism

Cha

Shin

et al. 2016

Journal of Infection and Chemotherapy

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Septic pulmonary embolism due to periodontal disease

Abstract: Most patients with SPE-PD were not seriously ill. Contrast-enhanced chest CT appeared to be useful to diagnose SPE-PD.

Cited by 13 publications

References 11 publications

Septic pulmonary embolism in China: clinical features and analysis of prognostic factors for mortality in 98 cases

Septic pulmonary embolism in China: clinical features and analysis of prognostic factors for mortality in 98 cases

Septic pulmonary embolism associated with periodontal disease: a case report and literature review

Risk factors for mortality in patients with septic pulmonary embolism

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