PDF(Pubmed)
Abstract：
Porphyromonas gingivalis, a gram-negative oral anaerobe among more than more than 500 bacterial species that colonizing the oral cavity, is involved in the pathogenesis and prototypic polybacterial consortium of periodontitis. It is mainly found in oral infections and rarely present in other organ diseases. Here, we describe a 43-year-old man with underlying diabetes who developed hematogenous disseminated severe pneumonia after P. gingivalis had invaded the blood. Next-generation sequencing of early alveolar lavage fluid and blood samples confirmed the diagnosis. The patient\'s lung infection improved after targeted antimicrobial treatment. He was successfully weaned from ventilatory support and transferred to the general ward. This case illustrates bacterial entry into the bloodstream of a patient with diabetes who had periodontal disease but did not maintain oral hygiene, leading to severe pneumonia. Periodontal disease is often ignored by the public, and it is difficult for critical care physicians to link severe pneumonia with periodontal disease. Thus, this case represents an important warning to critical care clinicians.
摘要：
牙龈卟啉单胞菌,一种革兰氏阴性口腔厌氧菌，在超过500种口腔定植的细菌中，参与牙周炎的发病机理和原型多细菌聚生体。它主要存在于口腔感染中，很少存在于其他器官疾病中。这里,我们描述了一名患有糖尿病的43岁男性患者,他在牙龈卟啉单胞菌侵入血液后出现血行播散性重症肺炎.早期肺泡灌洗液和血液样本的下一代测序证实了诊断。患者肺部感染经针对性抗菌治疗后好转。他成功地从通气支持中断奶，并转移到普通病房。此病例说明患有牙周病但未保持口腔卫生的糖尿病患者的细菌进入血液，导致严重的肺炎。牙周病经常被公众忽视，重症监护医生很难将重症肺炎与牙周病联系起来。因此，这一病例对重症监护临床医生来说是一个重要的警告.
