Stroke Caused by Vasculitis Induced by Periodontitis-Associated Oral Bacteria after Wisdom Teeth Extraction
Abstract
1. Introduction
2. Case Presentation
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Okabe, K.; Nakagawa, K.; Yamamoto, E. Factors affecting the occurrence of bacteremia associated with tooth extraction. Int. J. Oral Maxillofac. Surg. 1995, 24, 239–242. [Google Scholar] [CrossRef] [PubMed]
- Martins, C.C.; Lockhart, P.B.; Firmino, R.T.; Kilmartin, C.; Cahill, T.J.; Dayer, M.; Occhi-Alexandre, I.G.P.; Lai, H.; Ge, L.; Thornhill, M.H. Bacteremia following different oral procedures: Systematic review and meta-analysis. Oral Dis. 2023, 30, 846–854. [Google Scholar] [CrossRef] [PubMed]
- Minassian, C.; D’Aiuto, F.; Hingorani, A.D.; Smeeth, L. Invasive Dental Treatment and Risk for Vascular Events. Ann. Intern. Med. 2010, 153, 499–506. [Google Scholar] [CrossRef] [PubMed]
- Shahi, S.; Farhoudi, M.; Dizaj, S.M.; Sharifi, S.; Sadigh-Eteghad, S.; Goh, K.W.; Ming, L.C.; Dhaliwal, J.S.; Salatin, S. The Link between Stroke Risk and Orodental Status—A Comprehensive Review. J. Clin. Med. 2022, 11, 5854. [Google Scholar] [CrossRef] [PubMed]
- Luthra, S.; Orlandi, M.; Leira, Y.; Bokre, D.; Marletta, D.; Rotundo, R.; Harden, S.; D’Aiuto, F. Invasive dental treatment and acute vascular events: A systematic review and meta-analysis. J. Clin. Periodontol. 2022, 49, 467–479. [Google Scholar] [CrossRef]
- Dewan, M.; Pandit, A.K.; Goyal, L. Association of periodontitis and gingivitis with stroke: A systematic review and meta-analysis. Dent. Med. Probl. 2023. [Google Scholar] [CrossRef] [PubMed]
- Shobha, N.; Bhatia, R.; Barber, P.A. Dental procedures and stroke: A case of vertebral artery dissection. J. Can. Dent. Assoc. 2010, 76, a82. [Google Scholar] [PubMed]
- Parahitiyawa, N.B.; Jin, L.J.; Leung, W.K.; Yam, W.C.; Samaranayake, L.P. Microbiology of odontogenic bacteremia: Beyond endocarditis. Clin. Microbiol. Rev. 2009, 22, 46–64. [Google Scholar] [CrossRef]
- Tomás, I.; Álvarez, M.; Limeres, J.; Potel, C.; Medina, J.; Diz, P. Prevalence, duration and aetiology of bacteraemia following dental extractions. Oral Dis. 2007, 13, 56–62. [Google Scholar] [CrossRef]
- Tomás, I.; Pereira, F.; Llucián, R.; Poveda, R.; Diz, P.; Bagán, J.V. Prevalence of bacteraemia following third molar surgery. Oral Dis. 2008, 14, 89–94. [Google Scholar] [CrossRef]
- Ewald, C.; Kuhn, S.; Kalff, R. Pyogenic infections of the central nervous system secondary to dental affections—A report of six cases. Neurosurg. Rev. 2006, 29, 163–166, discussion 166–167. [Google Scholar] [CrossRef]
- Iida, Y.; Honda, K.; Suzuki, T.; Matsukawa, S.; Kawai, T.; Shimahara, T.; Chiba, H. Brain abscess in which Porphyromonas gingivalis was detected in cerebrospinal fluid. Br. J. Oral Maxillofac. Surg 2004, 42, 180. [Google Scholar] [CrossRef] [PubMed]
- González Navarro, B.; Jané Salas, E.; Estrugo Devesa, A.; López López, J.; Viñas, M. Bacteremia Associated With Oral Surgery: A Review. J. Evid. Based. Dent. Pract. 2017, 17, 190–204. [Google Scholar] [CrossRef] [PubMed]
- Balejo, R.D.P.; Cortelli, J.R.; Costa, F.O.; Cyrino, R.M.; Aquino, D.R.; Cogo-Müller, K.; Miranda, T.B.; Moura, S.P.; Cortelli, S.C. Effects of chlorhexidine preprocedural rinse on bacteremia in periodontal patients: A randomized clinical trial. J. Appl. Oral Sci. 2017, 25, 586–595. [Google Scholar] [CrossRef]
- Hirschfeld, J.; Kawai, T. Oral inflammation and bacteremia: Implications for chronic and acute systemic diseases involving major organs. Cardiovasc. Hematol. Disord. Drug Targets 2015, 15, 70–84. [Google Scholar] [CrossRef] [PubMed]
- O’Donnell, M.J.; Chin, S.L.; Rangarajan, S.; Xavier, D.; Liu, L.; Zhang, H.; Rao-Melacini, P.; Zhang, X.; Pais, P.; Agapay, S.; et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): A case-control study. Lancet 2016, 388, 761–775. [Google Scholar] [CrossRef]
- Sen, S.; Giamberardino, L.D.; Moss, K.; Morelli, T.; Rosamond, W.D.; Gottesman, R.F.; Beck, J.; Offenbacher, S. Periodontal Disease, Regular Dental Care Use, and Incident Ischemic Stroke. Stroke 2018, 49, 355–362. [Google Scholar] [CrossRef]
- Zheng, X.; Li, X.; Zhen, J.; Xue, D.; Hu, J.; Cao, Q.; Xu, A.; Cheung, B.M.Y.; Wu, J.; Li, C. Periodontitis is associated with stroke. J. Transl. Med. 2023, 21, 697. [Google Scholar] [CrossRef] [PubMed]
- Alfaddagh, A.; Martin, S.S.; Leucker, T.M.; Michos, E.D.; Blaha, M.J.; Lowenstein, C.J.; Jones, S.R.; Toth, P.P. Inflammation and cardiovascular disease: From mechanisms to therapeutics. Am. J. Prev. Cardiol. 2020, 4, 100130. [Google Scholar] [CrossRef]
- Fagundes, N.C.F.; Almeida, A.; Vilhena, K.F.B.; Magno, M.B.; Maia, L.C.; Lima, R.R. Periodontitis As A Risk Factor For Stroke: A Systematic Review And Meta-Analysis. Vasc. Health Risk Manag. 2019, 15, 519–532. [Google Scholar] [CrossRef]
- Van der Cruyssen, F.; Grisar, K.; Maes, H.; Politis, C. Case of a cerebral abscess caused by Porphyromonas gingivalis in a subject with periodontitis. BMJ Case Rep. 2017, 2017. [Google Scholar] [CrossRef] [PubMed]
- Zhang, Y.; Zhu, Y.; Wan, H. Case report:Multiple abscesses caused by Porphyromonas gingivalis diagnosed by metagenomic next-generation sequencing. Front. Med. 2022, 9, 1089863. [Google Scholar] [CrossRef] [PubMed]
- Huang, G.; Zhou, X.; Zhang, Z.; Lai, W.; Zhong, Q.; Wu, D.; Ye, X. Acute Porphyromonas gingivalis Subdural Abscess with Brain Abscess in the Left Temporal Lobe: A Case Report and Review of Literature. Infect. Drug Resist. 2023, 16, 6487–6491. [Google Scholar] [CrossRef]
- Lamtri Laarif, M.; Schils, R.; Lifrange, F.; Valkenborgh, C.; Pitti, P.; Brouwers, P.; Bianchi, E.; Meex, C.; Hayette, M.P. Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: Case report. Access Microbiol. 2023, 5, 000499.v4. [Google Scholar] [CrossRef]
- Park, K.; Hur, K.H.; Sung, H.; Kim, M.N. Culture-Negative Fusobacterium nucleatum Brain Abscess and Pleural Empyema Cases Revealed by 16S rRNA Sequencing. Clin. Lab. 2023, 69, 813–816. [Google Scholar] [CrossRef] [PubMed]
- Chen, K.P.; Lee, Y.P.; Hwang, M.J.; Chiang, C.P. Fusobacterium nucleatum-caused brain abscess—Case report. J. Dent. Sci. 2021, 16, 776–777. [Google Scholar] [CrossRef] [PubMed]
- Chen, K.C.; Sun, J.M.; Hsieh, C.T. Brain abscess caused by Parvimonas micra: A rare case report and literature review. Anaerobe 2023, 80, 102711. [Google Scholar] [CrossRef] [PubMed]
- Prieto, R.; Callejas-Díaz, A.; Hassan, R.; de Vargas, A.P.; López-Pájaro, L.F. Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses. Surg. Neurol. Int. 2020, 11, 140. [Google Scholar] [CrossRef] [PubMed]
- Cesta, N.; Foroghi Biland, L.; Neri, B.; Mossa, M.; Campogiani, L.; Caldara, F.; Zordan, M.; Petruzziello, C.; Monteleone, G.; Fontana, C.; et al. Multiple hepatic and brain abscesses caused by Parvimonas micra: A case report and literature review. Anaerobe 2021, 69, 102366. [Google Scholar] [CrossRef]
- Ruan, Q.; Guan, P.; Qi, W.; Li, J.; Xi, M.; Xiao, L.; Zhong, S.; Ma, D.; Ni, J. Porphyromonas gingivalis regulates atherosclerosis through an immune pathway. Front. Immunol. 2023, 14, 1103592. [Google Scholar] [CrossRef]
- Corrêa, J.D.; Fernandes, G.R.; Calderaro, D.C.; Mendonça, S.M.S.; Silva, J.M.; Albiero, M.L.; Cunha, F.Q.; Xiao, E.; Ferreira, G.A.; Teixeira, A.L.; et al. Oral microbial dysbiosis linked to worsened periodontal condition in rheumatoid arthritis patients. Sci. Rep. 2019, 9, 8379. [Google Scholar] [CrossRef]
- Azimi, S.; Klementiev, A.D.; Whiteley, M.; Diggle, S.P. Bacterial Quorum Sensing During Infection. Annu. Rev. Microbiol. 2020, 74, 201–219. [Google Scholar] [CrossRef]
- Hughes, D.T.; Sperandio, V. Inter-kingdom signalling: Communication between bacteria and their hosts. Nat. Rev. Microbiol. 2008, 6, 111–120. [Google Scholar] [CrossRef]
- Jakobsen, T.H.; van Gennip, M.; Phipps, R.K.; Shanmugham, M.S.; Christensen, L.D.; Alhede, M.; Skindersoe, M.E.; Rasmussen, T.B.; Friedrich, K.; Uthe, F.; et al. Ajoene, a sulfur-rich molecule from garlic, inhibits genes controlled by quorum sensing. Antimicrob. Agents Chemother. 2012, 56, 2314–2325. [Google Scholar] [CrossRef]
- Wright, P.P.; Ramachandra, S.S. Quorum Sensing and Quorum Quenching with a Focus on Cariogenic and Periodontopathic Oral Biofilms. Microorganisms 2022, 10, 1783. [Google Scholar] [CrossRef]
- Tobias, N.J.; Brehm, J.; Kresovic, D.; Brameyer, S.; Bode, H.B.; Heermann, R. New Vocabulary for Bacterial Communication. ChemBioChem 2020, 21, 759–768. [Google Scholar] [CrossRef]
- Lustri, B.C.; Sperandio, V.; Moreira, C.G. Bacterial Chat: Intestinal Metabolites and Signals in Host-Microbiota-Pathogen Interactions. Infect. Immun. 2017, 85, e00476-17. [Google Scholar] [CrossRef]
- Du, X.; Tang, Z.; Yan, L.; Zhang, L.; Zheng, Q.; Zeng, X.; Hu, Q.; Tian, Q.; Liang, L.; Zhao, X.; et al. Norepinephrine may promote the progression of Fusobacterium nucleatum related colorectal cancer via quorum sensing signalling. Virulence 2024, 15, 2350904. [Google Scholar] [CrossRef]
- Neuman, H.; Debelius, J.W.; Knight, R.; Koren, O. Microbial endocrinology: The interplay between the microbiota and the endocrine system. FEMS Microbiol. Rev. 2015, 39, 509–521. [Google Scholar] [CrossRef]
- Borsa, L.; Dubois, M.; Sacco, G.; Lupi, L. Analysis the Link between Periodontal Diseases and Alzheimer’s Disease: A Systematic Review. Int. J. Environ. Res. Public Health 2021, 18, 9312. [Google Scholar] [CrossRef]
- Arteagoitia, I.; Rodriguez Andrés, C.; Ramos, E. Does chlorhexidine reduce bacteremia following tooth extraction? A systematic review and meta-analysis. PLoS ONE 2018, 13, e0195592. [Google Scholar] [CrossRef]
Sample | Examinations | Result |
---|---|---|
CSF | General bacteriology | Negative No growth of aerobic or anaerobic microorganisms |
data | data | |
CSF | Mycobacteria | Negative Mycobacterium tuberculosis complex: negative |
CSF | Syphilis | Negative Treponema pallidum antibodies negative |
CSF | Borrelia | Negative Borrelia burgdorferi IgG & IgM antibody ELISA: negative |
CSF | Listeria monocytogenes | Negative |
CSF | Molecular Biological Diagnostics (16S rRNA gene PCR) | Negative No evidence of bacterial DNA |
CSF | Multiplex PCR for Diagnosis of Mycoplasma pneumoniae/Chlamydia pneumoniae | Negative Multiplex PCR: negative |
CSF | Zygomycetes | Negative Zygomycetes: negative |
CSF | Cryptococcus mycosis | Negative Cryptococcus mycosis: negative |
CSF | Molecular Biological Diagnostics of mycotic DNA (18S rRNA gene PCR) | Negative No evidence of mycotic DNA |
Blood | General bacteriology (Aerobic and anaerobic blood cultures) | Negative No growth of bacteria and sprout fungi |
Blood | Tuberculosis Quantiferon Set | Positive QuantiFERON-TB Gold |
Blood | Zygomycetes Diagnosis of Brucellosis | Negative No serological evidence of infection |
Blood | Beta-d-Glucan for Diagnosis of Pneumocystis Pneumonia | Negative No indication of an invasive mycosis or pneumonia caused by Pneumocystis jirovecii |
Sample | Examinations | Result |
---|---|---|
CSF & Blood | NGS (Noscendo GmbH) | Positive for: Fusobacterium nucleatum, Porphyromonas gingivalis, Tannerella forsythia, Parvimonas micra, Campylobacter showae |
Biopsy TMJ right | NGS (Noscendo GmbH) | Negative No growth of bacteria or fungi |
Biopsy Musculus pterygoideus lateralis right | NGS (Noscendo GmbH) | Positive for: Saccharomyces cerevisiae Porphyromonas gingivalis, Desulformicrobium orale Fusobacterium nucleatum, Bacilus cereus, Tannerella forsythia, Pseudobacterium alactolyticus Entarnoeba histolytica, Escherichia coli Dialister pneumosintes Aspergillus carbonarius Parvimonas micra, |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kiramira, D.; Uphaus, T.; Othman, A.; Heermann, R.; Deschner, J.; Müller-Heupt, L.K. Stroke Caused by Vasculitis Induced by Periodontitis-Associated Oral Bacteria after Wisdom Teeth Extraction. Brain Sci. 2024, 14, 550. https://doi.org/10.3390/brainsci14060550
Kiramira D, Uphaus T, Othman A, Heermann R, Deschner J, Müller-Heupt LK. Stroke Caused by Vasculitis Induced by Periodontitis-Associated Oral Bacteria after Wisdom Teeth Extraction. Brain Sciences. 2024; 14(6):550. https://doi.org/10.3390/brainsci14060550
Chicago/Turabian StyleKiramira, David, Timo Uphaus, Ahmed Othman, Ralf Heermann, James Deschner, and Lena Katharina Müller-Heupt. 2024. "Stroke Caused by Vasculitis Induced by Periodontitis-Associated Oral Bacteria after Wisdom Teeth Extraction" Brain Sciences 14, no. 6: 550. https://doi.org/10.3390/brainsci14060550
APA StyleKiramira, D., Uphaus, T., Othman, A., Heermann, R., Deschner, J., & Müller-Heupt, L. K. (2024). Stroke Caused by Vasculitis Induced by Periodontitis-Associated Oral Bacteria after Wisdom Teeth Extraction. Brain Sciences, 14(6), 550. https://doi.org/10.3390/brainsci14060550