Jpn. J. Infect. Dis., 62 (5), 381-383, 2009
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An Unusual Autopsy Case of Pyogenic Liver Abscess Caused by Periodontal Bacteria
Hideki Ohyama*, Keiji Nakasho, Koji Yamanegi, Yuichiro Noiri1, Ayako Kuhara, Nahoko Kato-Kogoe, Naoko Yamada, Masaki Hata, Fusanori Nishimura2, Shigeyuki Ebisu1, and Nobuyuki Terada
Department of Pathology, Hyogo College of Medicine, Hyogo 663-8501; 1Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka 565-0871; and 2Department of Dental Science for Health Promotion, Division of Cervico-Gnathostomatology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima 734-8553, Japan
(Received May 13, 2009. Accepted July 1, 2009)
*Corresponding author: Mailing address: Department of Pathology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan. Tel: +81-798-45-6432, Fax: +81-798-45-6431, E-mail: firstname.lastname@example.org
SUMMARY: 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.
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