Septic Pulmonary Embolism Ascribed to Periapical Periodontitis:: A Case Report and Review of the Literature

Abstract

Septic pulmonary embolism is a rare condition, the common sources of which are bacterial endocarditis and infected venous catheters. Septic pulmonary embolism ascribed to dental infection is extremely rare. The present report describes a case of septic pulmonary embolism attributed to periapical periodontitis in a 39-year-old patient, who was admitted with persistent toothache, fever, and chest pain. Chest CT showed a feeding vessel sign and a target sign. A panoramic radiograph of the left maxillary bone showed alveolar bone loss in a horizontal pattern typical of periodontitis and periapical periodontitis. The patient was treated with intravenous antibiotics and teeth extraction. To our knowledge, only 4 cases of septic pulmonary embolism ascribed to dental infection have been reported in the English literature. These patients repeatedly developed dental infections but did not receive appropriate dental treatment including extraction of the causative teeth, leading to the development of septic pulmonary embolism. This paper may contribute to the limited clinical knowledge base regarding septic pulmonary embolism ascribed to periapical periodontitis. Effective oral care and removal of the primary source of infection, including extraction of the causative teeth, are important to prevent septic pulmonary embolism.