title: An unusual autopsy case of pyogenic liver abscess caused by periodontal bacteria.
abstract: Pyogenic liver abscess (PLA) formation is thought to originate from the transmission of infection via three major routes including the biliary tract, portal vein and hepatic artery. However, about 50% of PLA cases are considered to be cryptogenic. Here we report an unusual autopsy case of PLA associated with periodontopathic bacterial infection. A 59-year-old female suddenly developed cardiopulmonary arrest and died. Despite macroscopic and microscopic examinations, the infectious routes and source of infection were unidentified, and the case appeared to be cryptogenic. Since this patient had suffered severe periodontitis for a long period of time, we investigated the involvement of periodontal infection in PLA formation by performing immunohistochemical analyses. We identified several periodontopathic bacterial species in the PLA of this patient, including Fusobacterium nucleatum, Treponema denticola, Prevotella intermedia and Porphyromonas gingivalis. Thus, we demonstrate here that periodontal infection is a potential source of infection in the formation of PLA.
authors.affiliation: Department of Pathology, Hyogo College of Medicine, Hyogo 663-8501, Japan. ohyama@hyo-med.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohyama
authors.forename: Keiji
authors.initials: K
authors.lastname: Nakasho
authors.forename: Koji
authors.initials: K
authors.lastname: Yamanegi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Noiri
authors.forename: Ayako
authors.initials: A
authors.lastname: Kuhara
authors.forename: Nahoko
authors.initials: N
authors.lastname: Kato-Kogoe
authors.forename: Naoko
authors.initials: N
authors.lastname: Yamada
authors.forename: Masaki
authors.initials: M
authors.lastname: Hata
authors.forename: Fusanori
authors.initials: F
authors.lastname: Nishimura
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Ebisu
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Terada
mesh_terms: D001344:Autopsy; D017809:Fatal Outcome; D005260:Female; D016967:Fusobacterium nucleatum / Q000302:isolation & purification*; D006801:Humans; D007668:Kidney / Q000473:pathology; D008099:Liver / Q000473:pathology; D046290:Liver Abscess, Pyogenic / Q000382:microbiology*; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D010510:Periodontal Diseases / Q000150:complications*; D016966:Porphyromonas gingivalis / Q000302:isolation & purification*; D018713:Prevotella intermedia / Q000302:isolation & purification*; D048373:Treponema denticola / Q000302:isolation & purification*