title: Febrile neutropenia and periodontitis: lessons from a case periodontal treatment in the intervals between chemotherapy cycles for leukemia reduced febrile neutropenia.
abstract: OBJECTIVE
  Oral and systemic infections arising from the oral cavity are significant problems in clinical management of patients undergoing leukemia treatment. However, there is significant disparity in the reported incidences of development of periodontal infections. Evidence is limited to those showing the systemic influence of periodontal infection in neutropenic patients. This study indicated an association between febrile neutropenia (FN) and periodontitis in a case in which periodontal treatment in the intervals between chemotherapy cycles reduced FN in subsequent courses of chemotherapy and hematopoietic transplantation (HCT).
  
  
  METHODS
  Periodontal treatment was performed in a 61-year-old man with advanced periodontitis, who received HCT following three cycles of chemotherapy. After recovery from neutropenia induced by initial chemotherapy, periodontal treatment was performed in each chemotherapy interval period. Following extraction of teeth with severe advanced periodontitis, all teeth were subjected to periodontal pocket curettage and root planning, which are common periodontal treatments to reduce periodontal pockets harboring anaerobic periodontal bacteria, before HCT.
  
  
  RESULTS
  Periodontal treatment successfully reduced periodontal pockets from 4.1 +/- 1.5 mm to 3.0 +/- 0.6 mm, which was almost within the healthy range (<3.0 mm), before HCT. The frequency of FN decreased significantly with increasing cycles of chemotherapy, and decreases in FN corresponded to progress of periodontal treatment. Blood cultures obtained a total of 12 times throughout leukemia treatment were all negative.
  
  
  CONCLUSIONS
  The observations reported here indicate the importance of periodontal treatment in clinical management of patients undergoing leukemia treatment to prevent FN, although all blood cultures were negative.
authors.affiliation: Department of Pathophysiology-Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8525, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Soga
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Yamasuji
authors.forename: Chieko
authors.initials: C
authors.lastname: Kudo
authors.forename: Kaori
authors.initials: K
authors.lastname: Matsuura-Yoshimoto
authors.forename: Kokoro
authors.initials: K
authors.lastname: Yamabe
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sugiura
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maeda
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Ishimaru
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
authors.forename: Fusanori
authors.initials: F
authors.lastname: Nishimura
authors.forename: Shogo
authors.initials: S
authors.lastname: Takashiba
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005334:Fever / Q000139:chemically induced* / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced* / Q000517:prevention & control; D010518:Periodontitis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents