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

BMC Infect Dis. 2019 Jan 21;19(1):74. doi: 10.1186/s12879-019-3710-3.

Abstract

Background: 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.

Case presentation: 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.

Conclusions: This case study demonstrated that periodontal disease is an important primary source of SPE and P. micra could be a causative pathogen of SPE.

Keywords: Parvimonas micra; Periodontal disease; Septic pulmonary embolism.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abscess / complications
  • Abscess / microbiology
  • Aged, 80 and over
  • Bacteremia / microbiology
  • Firmicutes / pathogenicity
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Male
  • Periodontal Diseases / complications*
  • Periodontitis / complications
  • Periodontitis / microbiology
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / etiology*
  • Pulmonary Embolism / microbiology
  • Tomography, X-Ray Computed