Association between periodontal disease and septicemia due to pyogenic hepatic abscess

Análida Elizabeth Pinilla Roa,Martha Isabel Murcia,Myriam Consuelo López Páez

doi:10.15446/revfacmed.v62n4.43147

Análida Elizabeth Pinilla Roa, Martha Isabel Murcia + Show 1 more

Open Access

https://doi.org/10.15446/revfacmed.v62n4.43147

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Abstract

Case of a 65 year-old man with type-2 diabetes mellitus for 15 years who complained of abdominal pain in the right upper quadrant associated with unquantified fever and weight loss over a period of 25 days. In the emergency room, he presented tachycardia, tachypnea and fever of 37 º C, diffuse abdominal pain from light palpation without peritoneal irritation or right upper quadrant tenderness upon fist percussion test. Within a few hours the patient evolved to septic shock and required transfer to the intermediate care unit. The abdominal computerized axial tomography showed multiloculated hepatic abscess. Percutaneous drainage was performed with the culture positive for Escherichia coli and Fusobacterium spp. Then, the differential diagnosis was made between pyogenic or amebic liver abscess. Subsequently, oral cavity examination revealed severe periodontal disease with coronal destruction; therefore, extraction was scheduled.

Highlights

Resumen favorecer el desarrollo de infecciones a distancia como: endocarditis, abscesos piógenos en diferentes órganos como cerebro, hígado, riñón, entre otros
Bacterial infections of the oral cavity —and gingival and periodontal infections— are responsible for bacteremias that, depending on the clinical history of the patient, can favor the development of remote infections like endocarditis, and pyogenic abscesses in different organs. These situations may be more frequent and profuse if the patient has an immunosuppression disorder caused by diabetes mellitus, HIV, or malnutrition, or corticosteroids or cytostatics indicated in the case of tumors or organ transplants [1,2,3] it is important to create an appropriate clinical history
The germs isolated with the greatest frequency in the hemocultures and from the purulent material obtained from the drainage of the pyogenic hepatic abscess (PHA) were: Klebsiella pneumoniae, Escherichia coli and Enterococcus spp [5,6]

Summary

Introduction

Resumen favorecer el desarrollo de infecciones a distancia como: endocarditis, abscesos piógenos en diferentes órganos como cerebro, hígado, riñón, entre otros. Bacterial infections of the oral cavity —and gingival and periodontal infections— are responsible for bacteremias that, depending on the clinical history of the patient, can favor the development of remote infections like endocarditis, and pyogenic abscesses in different organs (e.g. brain, liver, kidney, etc.). These situations may be more frequent and profuse if the patient has an immunosuppression disorder caused by diabetes mellitus, HIV, or malnutrition, or corticosteroids or cytostatics indicated in the case of tumors or organ transplants [1,2,3] it is important to create an appropriate clinical history. The germs isolated with the greatest frequency in the hemocultures and from the purulent material obtained from the drainage of the PHA were: Klebsiella pneumoniae, Escherichia coli and Enterococcus spp [5,6]

Findings

Discussion

Conclusion