歯性感染症が原因で生じたと考えられた敗血症性肺塞栓症の1例

概要

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Septic pulmonary embolism (SPE) is an uncommon disorder in which an infectious embolic blood clot leads to an infarction in the pulmonary vasculature, potentially causing death. We report the case of a 61-yearold woman with SPE caused by odontogenic infection. She was referred to our department because of limited mouth opening and pain of the left side of the maxilla. Her medical history included diabetes mellitus for the past 10 years. Physical examination showed a high fever (38.8 ゜C) and no chest pain. Laboratory tests showed an elevated white blood cell count <12,600/μl) , an elevated C-reactive protein level (10.65mg/dl), and an HbA1c of 7.7 %. A CT scan at presentation revealed an abscess in the masticator space and SPE in the upper lung field. After consulting pulmonologists, antibiotics were intravenously administered. Twelve days after initial presentation, another CT scan revealed improvement of the abnormal findings in the lung. Thereafter, the clinical course was uneventful, and no signs of recurrence have occurred for 2 years. This case demonstrates the importance of investigating SPE by chest CT in compromised patients who have suppurative foci in the oral and maxillofacial region.
Japanese Society of Oral and Maxillofacial Surgeonsの論文