Treatment-refractory-dental-extraction-associated pyothorax involving infection by 2 species of oral originated bacteria requires surgical debridement by video assisted thoracoscopic surgery (VATS)

Kammei Rai, Kiyoshi Matsuo, Toshiro Yonei, Toshio Sato

Research output: Contribution to journalArticle

Abstract

Cases of septic pulmonary embolism (SPE) diagnosed clinically by CT after dental extraction rarely include verification of bacteria from the local infection site. We report the case of a 70-year-old man without background disease suffering severe pyothrax after dental extraction. We detected two species of oral bacteria from his pleural effusion. Treatment was so difficult that it required surgical debridement by video assisted thoracoscopic surgery (VATS), even after the appropriate administration of antibiotics. According to the American Heart Association (AHA) prophylaxis guidelines for preventing infective endocarditis indicate that it is uncommon to prescribe antibiotics to patients without background disease after dental extraction. No appropriate Japanese guidelines exist considering the prevention of SPE causing severe pyothorax as in our case. The hematogenous spread of bacteria such as SPE caused by sepsis after tooth extraction thus requires more attended careful consideration in clinical practice if patients are to be properly protected against potentially serious complications.

Original languageEnglish
Pages (from-to)461-465
Number of pages5
JournalKansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases
Volume82
Issue number5
DOIs
Publication statusPublished - Sep 2008

ASJC Scopus subject areas

  • Medicine(all)

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