title: Septic pulmonary embolism due to periodontal disease.
abstract: OBJECTIVE
  Septic pulmonary embolism due to periodontal disease (SPE-PD) is rarely reported and little is known about its clinical features. The purpose of this study was to evaluate the clinical and radiological features, as well as outcome, in SPE-PD.
  
  
  METHODS
  Patients' records were retrospectively reviewed and 12 patients with SPE-PD were identified (10 men, mean age 60.5 years). The patients' demographic features, laboratory data, physical and radiological findings, and clinical outcomes were evaluated.
  
  
  RESULTS
  All but one patient were smokers. Eight of the 12 patients had comorbidities including hypertension (58%) and/or diabetes mellitus (17%). Prevalent symptoms were fever (67%) and chest pain (58%). Only two patients fulfilled the criteria of systemic inflammatory response syndrome; most of the subjects were not clinically severely ill. Blood cultures were negative in all cases. Contrast-enhanced chest computed tomography (CT) showed multiple peripheral nodules in all 12 patients, wedge-shaped peripheral lesions abutting on the pleura in 10 (83%) and a feeding-vessel sign in 9 (75%). All patients recovered from their illness after antimicrobial therapy concomitant with tooth extraction or periodontal care. The median duration of antibiotic administration was 51 days.
  
  
  CONCLUSIONS
  Most patients with SPE-PD were not seriously ill. Contrast-enhanced chest CT appeared to be useful to diagnose SPE-PD.
authors.affiliation: Respiratory Disease Center, the Tazuke Kofukai Medical Research Institute, Kitano Hospital, Ohgimachi, Kita-ku, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hatani
authors.forename: Masaya
authors.initials: M
authors.lastname: Takemura
authors.forename: Daiki
authors.initials: D
authors.lastname: Inoue
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Takamatsu
authors.forename: Manabu
authors.initials: M
authors.lastname: Ishitoko
authors.forename: Ryo
authors.initials: R
authors.lastname: Itotani
authors.forename: Shinko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuramoto
authors.forename: Motonari
authors.initials: M
authors.lastname: Fukui
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000150:complications*; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D014081:Tooth Extraction; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents