Journal of

Case Reports and Images in Dentistry

 
     
Case Report
 
Pyogenic liver abscesses derived from dental disease in an immunocompetent patient
Luis Sanches Fonseca1, Patrícia de Deus Caixeirinho1, Maria do Céu Machado1, Ana Vintém Oliveira2, Marvin Oliveira3, Jorge Manuel Pinheiro4
1Resident in Stomatology, Department of Stomatology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
2Consultant in Internal Medicine, Intensive Care Unit, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
3Resident in Clinical Pathology, Department of Clinical Pathology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
4Consultant in Stomatology, Department of Stomatology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal

Article ID: 100024Z07LF2018
doi: 10.5348/Z07-2018-24-CR

Corresponding Author:
Luis Sanches Fonseca,
Rua José António Serrano - Hospital de S. José - Serviço
de Estomatologia, 1150-199,
Lisbon, Portugal

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How to cite this article
Fonseca LS, Caixeirinho PDD, Machado MDC, Oliveira AV, Oliveira M, Pinheiro JM. Pyogenic liver abscesses derived from dental disease in an immunocompetent patient. J Case Rep Images Dent 2018;4:100024Z07LF2018.


ABSTRACT
Introduction: Pyogenic liver abscess of odontogenic origin is extremely rare. The authors report a case of pyogenic liver abscesses with oral origin caused by Prevotella denticola and Streptococcus anginosus, in an immunocompetent adult.
Case Report: A 54-year-old healthy female was presented to our hospital with fever, pain in the right hypochondriac region, constipation, anorexia and history of toothache with gingival swelling. Abdominal X-ray presented showed signs of intestinal obstruction and computed tomography suggested two liver abscesses. The larger one, with 113 mm, was drained under percutaneous ultrasound guidance. Abscess culture isolated Prevotella denticola and Streptococcus anginosus. Under antibiotic therapy, the most common causes for liver abscess were excluded. Dental evaluation found multiple septic foci. Root extractions, dental restorations and periodontal treatments were performed. In this case, abscess culture result is highly suggestive of a dental origin, as species isolated are common oral pathogens. Along with the clinical findings, we are reassured about the original source of infection.
Conclusion: This case illustrates the underestimated risk associated with untreated dental diseases. We believe oral infectious foci removal is imperative as primary care. Due to the increase of the cryptogenic liver abscess, we find a systematic dental evaluation is required for the etiological diagnosis of liver abscess.

Keywords: Dental focal infections, Liver abscess, Prevotella denticola, Streptococcus anginosus


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Author Contributions
Luis Sanches Fonseca – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Patrícia de Deus Caixeirinho – Substantial contribution to conception and design, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Maria do Céu Machado – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Ana Vintém de Oliveira – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Marvin Oliveira – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Jorge Manuel Pinheiro – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of Submission
The corresponding author is the guarantor of submission.
Source of Support
None
Conflict of Interest
Authors declare no conflict of interest.
Copyright
© 2018 Luis Sanches Fonseca et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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