Periodontitis-associated septic pulmonary embolism caused by Actinomyces species identified by anaerobic culture of bronchoalveolar lavage fluid: A case report

Shun Endo, Eikan Mishima, Yoichi Takeuchi, Takashi Ohi, Masatsugu Ishida, Masaru Yanai, Hideyasu Kiyomoto, Tasuku Nagasawa, Sadayoshi Ito

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: Periodontal disease is a less common but important cause of septic pulmonary embolism (SPE). However, the pathogens causing periodontal disease-associated SPE (PD-SPE) have been poorly understood. Actinomyces species are resident microbiota in the oral cavity. Here we report a case of PD-SPE caused by Actinomyces species, which was identified by anaerobic culture of bronchoalveolar lavage fluid (BAL). Case presentation: A 64-year-old Asian man, complicated with severe chronic periodontitis, was admitted with chest pain and fever. Chest CT revealed multiple bilateral pulmonary nodules located subpleurally. We diagnosed the case as SPE associated with periodontitis. Although blood cultures were negative for the usual 5-day incubation, anaerobic culture of the BAL fluid sample yielded Actinomyces species. Antibacterial therapy alone did not ameliorate the symptoms; however, additional dental treatment, including tooth extraction, promptly did. The patient was discharged 23 days after admission. The 3-month follow-up revealed no recurrence of the symptoms and complete resolution of the lung lesions. Conclusion: This case demonstrated that Actinomyces species can cause PD-SPE. Additionally, clinicians should consider performing appropriate anaerobic culture of BAL fluid to identify the pathogen of SPE, and to ordering dental treatment, if necessary, in addition to antibiotics for the initial management of PD-SPE.

Original languageEnglish
Article number552
JournalBMC infectious diseases
Volume15
Issue number1
DOIs
Publication statusPublished - 2015 Dec 1

Keywords

  • Actinomyces species
  • Anaerobic culture
  • Bronchoalveolar lavage
  • Chest pain
  • Dental infection
  • Periodontitis
  • Septic pulmonary embolism

ASJC Scopus subject areas

  • Infectious Diseases

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