背景:在本报告中,我们讨论了一例39岁女性出现慢性上颌窦炎的病例。
方法:Dialisterpneumosintes,表皮葡萄球菌,和肽链球菌。从手术期间获得的内窦样本中分离。该患者表现出广泛的牙周病,并曾接受过牙髓治疗,以治疗#13,#14和#15的牙髓感染,失败并可能是鼻窦感染的桥梁。鼻窦手术后,包括上颌窦的开口和厕所,结合前面提到的3颗牙齿的拔除和抗生素治疗,病人显示完全愈合。
结果:S.表皮和肽链球菌属。用传统的生化测试鉴定,并通过焦磷酸测序证实。相反,用常规方法不能鉴定Pneumosintes,但它是用DNA焦磷酸测序鉴定的.此外,为了更好地了解这种细菌在牙源性鼻窦炎中的作用和毒力,我们已经评估了D.pneumosintes在惰性表面上产生生物膜的能力。pneumosintes是在坏死牙髓中发现的一种已知的牙髓和牙周病原体,龈下菌斑,和深牙周袋。
结论:据我们所知,D.pneumosintes在牙源性鼻窦炎中的致病作用从未得到证实。因此,它在内窦标本中的检测可能为这种相关医学疾病的发病机理提供了重要的见解。
BACKGROUND: In this report, we discuss the
case of a 39-year-old woman presenting with a
case of chronic maxillary sinusitis.
METHODS: Dialister pneumosintes, Staphylococcus epidermidis, and Peptostreptococcus spp. were isolated from endosinusal samples obtained during surgery. The patient showed extensive periodontopathy and had undergone prior endodontic treatment for endodontic infection of teeth #13, #14, and #15, which failed and presumably acted as a bridge for the sinusal infection. After nasosinusal surgery, consisting of opening and toilet of the maxillary sinus, combined with extraction of the 3 previously mentioned teeth and antibiotic treatment, the patient showed complete healing.
RESULTS: S. epidermidis and Peptostreptococcus spp. were identified with a traditional biochemical test and confirmed by
pyrosequencing. Conversely, D. pneumosintes could not be identified with the conventional method, but it was identified using DNA
pyrosequencing. In addition, to better understand the role and the virulence of this bacterium in odontogenic sinusitis, we have evaluated the ability of D. pneumosintes to produce biofilms onto inert surfaces. D. pneumosintes is a known endodontic and periodontal pathogen found in necrotic pulp, subgingival plaque, and deep periodontal pockets.
CONCLUSIONS: To our knowledge, the pathogenic role of D. pneumosintes in odontogenic sinusitis has never been evidenced. Thus, its detection in endosinusal specimens may provide a significant insight into the pathogenesis of this relevant medical condition.