Severe bacterial infection caused by poor oral hygiene

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Other Title
  • 口腔内不衛生に起因する重症感染症
  • 口腔内不衛生に起因する重症感染症 : 中枢神経障害を主たる症状とした二例の経験から
  • コウコウ ナイ フエイセイ ニ キイン スル ジュウショウ カンセンショウ : チュウスウ シンケイ ショウガイ オ シュタル ショウジョウ ト シタ ニレイ ノ ケイケン カラ
  • — Two cases with central nervous system disorder as the main symptom —
  • —中枢神経障害を主たる症状とした二例の経験から—

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Abstract

<p>  We report two cases of severe infectious disease due to poor oral hygiene. The first case was a 53‒year‒old man who was transported to our facility by ambulance due to fever, convulsions, and consciousness disorder. A computed tomography (CT) scan of the head and face revealed a left subdural abscess with extensive pus accumulation from the maxillary sinus to the frontal sinus, and decompressive subdural abscess lavage was performed. Alpha streptococcus was identified in bacterial culture. Intracranial infection subsided with large doses of antibiotics. The patient had untreated diabetes and was thought to have caused dental maxillary sinusitis, the subdural abscess, and a brain abscess due to the combination of poor oral hygiene and diabetes. His right hemiplegia and higher cerebral dysfunction improved gradually, and he is currently in rehabilitation to return to society. The second case was a 63‒year‒old man who was transported to our facility by ambulance due to fever, convulsions, and consciousness disorder. CT and magnetic resonance (MR) scans of the head revealed scattered bleeding and infarcts in the skull. Transthoracic echocardiography showed vegetation on the mitral valve. The patient was diagnosed with cardiogenic cerebral embolism associated with infectious endocarditis, and cerebral hemorrhage associated with ruptured bacterial aneurysm. He had no habit of brushing his teeth. He had recently gone to a dentist to start treating and brushing his teeth. He also had thrombocytopenia and presented with disseminated intravascular syndrome (DIC). Staphylococcus aureus was identified in bacterial culture. The patient died 4 days after admission due to progressing renal failure and intracranial hemorrhage. Systemic infections and central nervous system diseases associated with oral hygiene are rare but can occur in the general public. Caution may be required as such conditions may result in serious consequences.</p>

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