由牙脓肿引起的钩状绦虫感染可引起严重的肠道并发症和颌骨骨髓炎。

IF 1 Q3 SURGERY GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW Pub Date : 2021-04-14 eCollection Date: 2021-01-01 DOI:10.3205/iprs000152
Andreas Sakkas, Isabel Nolte, Sebastian Heil, Boris Mayer, Steffen Kargus, Robert A Mischkowski, Oliver C Thiele
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引用次数: 4

摘要

牙源性病灶可能导致全身性感染,通过连续的解剖腔传播细菌或血液传播。口腔病原体引起的继发性感染报告最多的是颅内脓肿。虽然,文献中很少有报道描述细菌扩散到颅外部位。病例描述:我们报告一名52岁男性白种人患者因下颌骨脓肿引起的严重脓毒症入住我院。在血液和脓肿材料中检测到链状绦虫(MALDI-TOF质谱法证实)。患者随后出现肝周脓肿和结肠穿孔,经多次手术治疗后病情稳定。他在医院接受了66天的静脉注射抗生素。5个月后,在左下颌骨发现放线菌污染的颌骨坏死,也必须手术治疗。最后一次手术后三年,没有发现复发的迹象。讨论:口腔颌面外科医生应该了解全身性感染的特点,其中潜在的口腔内牙源性病灶通常缺乏急性症状。如果没有发现其他感染源,则应消除潜在的牙源性病灶。然而,排除疑似因果牙的决策标准还需要更多的研究来阐明。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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

Introduction: 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. Case description: 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. Eggerthia catenaformis 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. Discussion: 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.

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