PDF(Pubmed)
Abstract：
Invasive dental procedures, such as wisdom teeth removal, have been identified as potential triggers for vascular events due to the entry of oral bacteria into the bloodstream, leading to acute vascular inflammation and endothelial dysfunction. This study presents the case of a 27-year-old healthy male who developed ischemic stroke resulting from bacteremia after undergoing wisdom teeth extraction. Initially, the patient experienced fever and malaise, which were followed by right-sided hemiplegia. Diagnostic imaging, including a CT scan, identified a subacute infarction in the posterior crus of the left internal capsule, and MRI findings indicated inflammatory changes in the masticatory muscles. Further investigations involving biopsies of the masticatory muscles, along with blood and cerebrospinal fluid samples, confirmed bacterial meningitis with associated vasculitis. Notably, oral bacteria linked to periodontitis, including Porphyromonas gingivalis, Fusobacterium nucleatum, Tannerella forsythia, and Parvimonas micra, were found in the biopsies and microbiological analyses. To the best of our knowledge, this is the first reported case showing that bacteremia following dental procedures can lead to such severe neurological outcomes. This case underscores the importance of recognizing bacteremia-induced vasculitis in patients presenting with neurological symptoms post-dental procedures, emphasizing the broader implications of oral infections in such pathologies.
摘要：
侵入性牙科手术，比如智齿拔除，已被确定为由于口腔细菌进入血液而导致的血管事件的潜在触发因素，导致急性血管炎症和内皮功能障碍。这项研究介绍了一名27岁的健康男性，该男性在接受智齿拔除后因菌血症而发生缺血性中风。最初，病人出现发烧和不适,其次是右侧偏瘫。诊断成像,包括CT扫描,发现左内囊小腿后部有亚急性梗死,MRI结果显示咀嚼肌有炎症改变。涉及咀嚼肌活检的进一步调查，连同血液和脑脊液样本，证实细菌性脑膜炎与相关血管炎。值得注意的是,与牙周炎有关的口腔细菌，包括牙龈卟啉单胞菌,具核梭杆菌,连翘坦菌,和Parvimonasmicra,在活检和微生物学分析中发现。据我们所知,这是第一例报道的病例，表明牙科手术后的菌血症会导致如此严重的神经系统结局。该病例强调了在牙科手术后出现神经系统症状的患者中认识菌血症引起的血管炎的重要性。强调口腔感染在此类疾病中的更广泛影响。
