title: Persistent infection by Staphylococcus epidermidis in endodontic flare-up: a case report.
abstract: Endodontic flare-ups are challenging situations and may result from selective growth of specific bacterial species; microbial cultures and antibiograms should be used to allow faster, successful management of refractory lesions. A 47-year-old man reported pain on percussion after uncomplicated retreatment of the maxillary left canine for prosthetic purposes. In the following days, pain dramatically increased, leading to removal of the filling and use of intracanal medication. After many unsuccessful attempts to resolve the problem, a microbial culture of the root canal detected the presence of Staphylococcus epidermidis. An antibiogram determined the best drug combination to control this infection: tetracycline (oxytetracycline hydrochloride, 500 mg orally) plus third-generation cephalosporin (ceftriaxone, 1 g intramuscularly). Once the infection was controlled, the root canal was obturated. There was a reduction in the area of radiolucency, and the patient reported no pain at a 2-year follow-up.
authors.forename: Simone Helena Ferreira
authors.initials: SH
authors.lastname: Gonçalves
authors.forename: Rafaela Andrade
authors.initials: RA
authors.lastname: de Vasconcelos
authors.forename: Bruno das Neves
authors.initials: Bd
authors.lastname: Cavalcanti
authors.forename: Carlos Henrique Ribeiro
authors.initials: CH
authors.lastname: Camargo
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D010118:Oxytetracycline / Q000008:administration & dosage / Q000627:therapeutic use; D012390:Root Canal Therapy / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D013212:Staphylococcus epidermidis; D000067251:Symptom Flare Up
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D010118:Oxytetracycline
keywords: Staphylococcus epidermidis; antibiotics; biofilm; endodontic flare-up; retreatment