A rare but potentially life-threatening infection after teeth cleaning!
The 57-year-old man in Pennsylvania presented with complaints of fever and pain in the right upper body. The patient had a recent history of a dental procedure. The patient had undergone a routine dental exam and teeth cleaning around 2 weeks back, which might be the reason behind the clinical manifestation.
Dr. Faton Bytyci, a resident physician at Sacred Heart Hospital in Allentown, Pennsylvania, said:
“It gets into the blood circulation and then lands into one of the big organs. I was trying to figure out where it was coming from.”
Dr. Faton Bytyci, a resident physician at Sacred Heart Hospital in Allentown, Pennsylvania, said:
“The type of infection that the man had is very rare, and the chances of getting this type of infection during a dental procedure are very low.”
Dr. Bytyci revealed that the patient, during his hospital stay, casually mentioned his visit to a dentist. Dr. Bytyci said:
“‘He (the patient) said I saw my dentist like two weeks ago. Then I was like, that would be one [source of infection].”
Diagnosis:
A magnetic resonance imaging of the abdomen was performed, which showed a pus pocket in the patient’s liver. The pus grew Fusobacterium necrophorum.
Fusobacterium is an anaerobic Gram-negative rod, which is a part of the normal flora of the throat but not of the liver. This infection, albeit rare, has a life-threatening course.
Although rare, these infections secondary to dental infections are quite rare, but to minimize the risk in high-risk patients, such as those with heart defects or a history of heart infection, it is recommended to prescribe antibiotics prophylactically.
The doctors drained the pus cavity from the liver, and he was started on antibiotics.
One week after starting treatment, the patient recovered substantially. He was discharged with a prescription of antibiotics for the following month.
At the 6-week follow-up, a computed tomography scan of the liver was performed, which came out to be normal. The pus cavity had resolved completely.
References:
Bytyci F, Khromenko E. Hepatic abscess caused by Fusobacterium necrophorum after a trip to the dentist, Case Reports 2016;2016:bcr2015210235.
Robertson DP, Keys W, Rautemaa-Richardson R, Burns R, Smith AJ. Management of severe acute dental infections. BMJ. 2015;350: h1300. doi: 10.1136/bmj.h1300
