Association between Periodontal Disease and Bacterial Endocarditis: case report

Authors

DOI:

https://doi.org/10.33448/rsd-v11i4.27186

Keywords:

Endocarditis, Bacterial; Periodontal diseases; Hospital dental staff.

Abstract

Periodontal Disease (PD) is an infectious and inflammatory condition that affects the oral cavity and is considered a risk factor for other systemic diseases, such as Bacterial Endocarditis (EB), due to the variety of pathogens that can cause bacteremia and colonize cardiac sites. Objective: To report a case about the relationship between PD and EB. Methodology: We report the case of a 53 year old patient, R.N.S., who sought medical attention after an afternoon fever and weight loss, and was diagnosed with pulmonary and urinary tract infection. After nine days, he was transferred to a High Complexity Hospital, and diagnosed with infective endocarditis with vegetation in the mitral valve, caloric malnutrition, and Acute Respiratory Syndrome. After 24 hours, he was referred to the Intensive Care Unit with tachypnea, drop in saturation, and mental confusion. After blood culture, the diagnosis was fungal infectious endocarditis by Candida tropicalis, with ventricular dysfunction. The dental evaluation showed a partial edentulous patient, calculus and dental biofilm, gingival recession on tooth 13, mobility on 31 and 32. Subgingival root scraping/straightening and exodontia of the 31 and 32 were performed in the operating room prior to cardiac surgery. Serratia marcescens was isolated from the culture of the periodontal abscess of tooth 13. The patient evolved without positive results for fungi in blood, tracheal secretion or urine culture. However, the same bacteria (S. marcescens) was present in blood and mitral valve samples. Conclusion: Dental evaluation should precede cardiac surgeries to avoid that oral infectious foci serve as a reservoir for opportunistic bacteria that may contribute to unfavorable outcomes such as EB by systemic dissemination of these pathogens.

References

Alegria, S., Marques, A., Cruz, I., Broa, A. L., Pereira, A. R. F., João, I., Simões, O., & Pereira, H. (2021). Neurological Complications in Patients With Infective Endocarditis: Insights From a Tertiary Centre. Arq. Bras. Cardiol., 116(4), 682–691. https://doi.org/10.36660/abc.20190586

Almerich-Silla, J., Alminana-Pastor, P., Boronat-Catala, M., Bellot-Arcis, C., & Montiel-Company, J. (2017). Socioeconomic Factors and Severity of Periodontal Disease in Adults (35-44 Years). A Cross Sectional Study. Journal of Clinical and Experimental Dentistry, 0–0. https://doi.org/10.4317/jced.54033

Araújo-Júnior, J. L. de, Magalhães, M. do C. F., Melo-Silva, E. M. V. de, Miranda, B. L., Gonçalves, M. A. F., Dias-Ribeiro, E., & Paiva, M. A. F. de. (2019). Associação entre Endocardite Bacteriana e Procedimento de Cirurgia e Traumatologia Bucomaxilofacial. Archives Of Health Investigation, 8(3). https://doi.org/10.21270/archi.v8i3.3177

Au, C. W. H., Yap, D. Y. H., Chan, J. F. W., Yip, T. P. S., & Chan, T. M. (2021). Exit Site Infection and Peritonitis Due to Serratia Species in Patients Receiving Peritoneal Dialysis: Epidemiology and Clinical Outcomes. Nephrology, 26(3), 255–261. https://doi.org/10.1111/nep.13813

Barroso, M. G.; Cortela, D. Da C. B.; Mota, W. P. Endocardite Bacteriana: da Boca ao Coração. Revista Ciência e Estudos Acadêmicos de Medicina, [S. l.], v. 1, n. 02, 2014. Disponível em: https://periodicos.unemat.br/index.php/revistamedicina/article/view/366.

Bruna, R. E., Molino, M. V., Lazzaro, M., Mariscotti, J. F., & García Véscovi, E. (2018). Cpxr-Dependent Thermoregulation of Serratia Marcescens Prta Metalloprotease Expression and its Contribution to Bacterial Biofilm Formation. Journal of Bacteriology, 200(8), e00006-18. https://doi.org/10.1128/JB.00006-18

Caceres, J., Sood, V., Farhat, L., & Yang, B. (2020). Aortic Valve Endocarditis With Anomalous Origin of the Right Coronary Artery and Unknown Infected Thrombus in the Dissected Descending Thoracic Aorta. Aorta, 08(03), 076–079. https://doi.org/10.1055/s-0040-1714715

Cahill, T. J., & Prendergast, B. D. (2016). Infective Endocarditis. The Lancet, 387(10021), 882–893. https://doi.org/10.1016/S0140-6736(15)00067-7

Cardoso, M. C. A. C., Cardoso, Á. B., Couto, G. R., Nascimento, Y. A. do, Melo, H. L. S. F. de, Amaral, R. C. do, Silva, J. A. S. da, & Meneses, I. S. de. (2021). Estudo da Prevalência de Alterações Periodontais em Pacientes Acometidos por Acidente Vascular Cerebral Isquêmico. Research, Society and Development, 10(5), e36910515153–e36910515153. https://doi.org/10.33448/rsd-v10i5.15153

Carinci, F., Martinelli, M., Contaldo, M., Santoro, R., Pezzetti, F., Lauritano, D., Candotto, V., Mucchi, D., Palmieri, A., Tagliabue, A., & Tettamanti, L. (2018). Focus On Periodontal Disease and Development of Endocarditis. Journal of biological regulators and homeostatic agents, 32(2 Suppl. 1), 143–147.

Carranza F.A., Newman M.G., Talkei H.H., Klokkevold P.R. (2007) Periodontia Clínica. Rio de Janeiro, Brasil: Elsevier.

Carrizales-Sepúlveda, E. F., Ordaz-Farías, A., Vera-Pineda, R., & Flores-Ramírez, R. (2018). Periodontal Disease, Systemic Inflammation and the Risk of Cardiovascular Disease. Heart, lung & circulation, 27(11), 1327–1334. https://doi.org/10.1016/j.hlc.2018.05.102

Carvalho, R. C., Leite, S. A., Rodrigues, V. P., Pereira, A. F., Ferreira, T. C., Nascimento, F. R., Nascimento, J. R., Gomes-Filho, I. S., Bastos, M. G., & Pereira, A. L. (2016). Chronic periodontitis and serum levels of hepcidin and hemoglobin. Oral diseases, 22(1), 75–76. https://doi.org/10.1111/odi.12373

Daalderop, L. A., Wieland, B. V., Tomsin, K., Reyes, L., Kramer, B. W., Vanterpool, S. F., & Been, J. V. (2018). Periodontal Disease and Pregnancy Outcomes: Overview Of Systematic Reviews. JDR Clinical & Translational Research, 3(1), 10–27. https://doi.org/10.1177/2380084417731097

Dörfer, C., Benz, C., Aida, J., & Campard, G. (2017). The Relationship of Oral Health with General Health and NCDS: A Brief Review. International Dental Journal, 67, 14–18. https://doi.org/10.1111/idj.12360

Elabd, H., Eagleston, A., Brandt, D., & Blatt, S. (2020). Characteristics and Trends of Serratia Blood Stream Infections. Open Forum Infectious Diseases, 7(1), S133–S134. https://doi.org/10.1093/ofid/ofaa439.311

Gomes‐Filho, I. S., Coelho, J. M. F., Miranda, S. S., Cruz, S. S., Trindade, S. C., Cerqueira, E. M. M., Passos‐Soares, J. S., Costa, M. da C. N., Vianna, M. I. P., Figueiredo, A. C. M. G., Hintz, A. M., Coelho, A. F., Passos, L. C. S., Barreto, M. L., & Scannapieco, F. (2020). Severe and Moderate Periodontitis are Associated with Acute Myocardial Infarction. Journal of Periodontology, 91(11), 1444–1452. https://doi.org/10.1002/JPER.19-0703

Gomes‐Filho, I. S., Cruz, S. S. da, Trindade, S. C., Passos‐Soares, J. de S., Carvalho‐Filho, P. C., Figueiredo, A. C. M. G., Lyrio, A. O., Hintz, A. M., Pereira, M. G., & Scannapieco, F. (2020). Periodontitis and Respiratory Diseases: A Systematic Review with Meta‐Analysis. Oral Diseases, 26(2), 439–446. https://doi.org/10.1111/odi.13228

Gonçalves, M. O. (2010). Expressão de Fatores de Virulência, Mecanismos de Resistência aos Agentes Antimicrobianos e Análise Molecular da Resistência aos Beta-Lactâmicos de Enterobactérias Isoladas de Bolsas Periodontais. (Tese de Doutorado, Universidade do Estado do Rio de Janeiro, RJ). https://www.bdtd.uerj.br:8443/handle/1/8558

Gleycielly da Mota Oliveira, S., Carolina de Lima, B., Rosa Natalia Rendall dos Santos, R., & Vivian Kelly Leite, P. (2019). Analysis of Protocols of Bucal Hygienization in Patients in The Intensive Therapy Unit(ICU). International Journal of Oral and Dental Health, 5(1). https://doi.org/10.23937/2469-5734/1510079

Grinberg, S., Bishburg, E., & Nagarakanti, S. R. (2020). Embolic Serratia Aortic Valve Endocarditis. IDCases, 22, e00953. https://doi.org/10.1016/j.idcr.2020.e00953

Hadano, Y., Kamiya, T., & Uenishi, N. (2012). A Fatal Case of Infective Endocarditis Caused by an Unusual Suspect: Serratia Marcescens. Internal Medicine, 51(11), 1425–1428. https://doi.org/10.2169/internalmedicine.51.6648

Hajishengallis, G., & Chavakis, T. (2021). Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nature Reviews Immunology, 21(7), 426–440. https://doi.org/10.1038/s41577-020-00488-6

Junior, D.S, Fukushigue, C.Y., Schmitt, B.H.E., Schmeling T.B. & Farias, M.M.A.G. (2019). Endocardite Infecciosa por Aggregatibacter Actinomycetemcomitans em Pacientes Predispostos. Rev. Soc. Cardiol Estado de Säo Paulo, 297-301. http://dx.doi.org/10.29381/0103-8559/20192903297-301

Kaura, A., Dworakowska, D., & Dworakowski, R. (2017). Infective endocarditis - Cinderella in Cardiology. Kardiologia polska, 75(10), 965–974. https://doi.org/10.5603/KP.a2017.0099

Larvin, H., Kang, J., Aggarwal, V. R., Pavitt, S., & Wu, J. (2021). Risk of Incident Cardiovascular Disease in People With Periodontal Disease: A Systematic Review and Meta‐Analysis. Clinical and Experimental Dental Research, 7(1), 109–122. https://doi.org/10.1002/cre2.336

Leite, S.A., Casanovas, R.C., Rodrigues, V.P., Pereira, A.F., Ferreira, T.C., Nascimento, F.R., Nascimento, J.R., Gomes-Filho, I.S., Bastos, M.G., & Pereira, A.L. (2019). The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels. Brazilian oral research, 33, e055 .

Lockhart, P. B., Brennan, M. T., Sasser, H. C., Fox, P. C., Paster, B. J., & Bahrani-Mougeot, F. K. (2008). Bacteremia Associated With Toothbrushing and Dental Extraction. Circulation, 117(24), 3118–3125. https://doi.org/10.1161/CIRCULATIONAHA.107.758524

Mang-de la Rosa, M.R., Castellanos-Cosano, L., Romero-Perez, MJ., & Cutando, A. (2014). The Bacteremia of Dental Origin and its Implications in ihe Appearance of Bacterial Endocarditis. Medicina Oral Patología Oral y Cirugia Bucal, e67–e74. https://doi.org/10.4317/medoral.19562

Marques, A., Cruz, I., Caldeira, D., Alegria, S., Gomes, A. C., Broa, A. L., João, I., & Pereira, H. (2019). Risk Factors for in-Hospital Mortality in Infective Endocarditis. Arquivos Brasileiros de Cardiologia, 114, 1–8. https://doi.org/10.36660/abc.20180194

Mills, J. (1976). Serratia Marcescens Endocarditis: A Regional Illness Associated With Intravenous Drug Abuse. Annals of Internal Medicine, 84(1), 29. https://doi.org/10.7326/0003-4819-84-1-29

Parente, T. M. L. (2010). Perfil de resistência a antibióticos e a terapia fotodinâmica antimicrobiana exibida por isolados ambientais, orais e extra-orais de Serratia marcescens. (Dissertação de Mestrado, Universidade Federal do Ceará, Sobral, CE). http://www.repositorio.ufc.br/handle/riufc/16293

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. Santa Maria, RS: UFSM, NTE. Disponível em: https://www.ufsm.br/app/uploads/sites/358/2019/02/Metodologia-da-Pesquisa-Cientifica_final.pdf

Queirós, R., Barreira A.I., Mesquina M.D., Costa A.O., Cunha J.V. & Guimarães F. (2019). Endocardite por Serratia Marcescens: Relato de um Caso Clínico e Revisão Da Literatura. Revista Portuguesa de Doenças Infecciosas, v. 15, n. 1, p. 34-41. http://spdimc.org/revista/

Rocha, S. C., Travassos, D. V., & Rocha, N. B. da. (2021). Os Benefícios da Odontologia Hospitalar para a População: Uma Revisão de Escopo. Research, Society and Development, 10(4), e33410414117. https://doi.org/10.33448/rsd-v10i4.14117

Sousa, L.P. (2021). Endocardite Infecciosa por Bactérias Gram-Negativas Não-HACEK: Estudo Multicêntrico. (Dissertação de Mestrado, Instituto Nacional de Cardiologia, Rio de Janeiro, RJ). http://200.20.108.73:8080/xmlui/handle/374/180

Sousa, J. P. D. L., Sousa, F. S., Souza, L.D., Corrêa, N. C., Rodrigues, V. P., Casanovas, R. C. (2019). Levantamento Das Ações De Cuidados Bucais Em Unidades De Terapia Intensiva Adulto No Contexto Multiprofissional. Rev Pesq Saúde, 20(2): 62-66. http://www.periodicoseletronicos.ufma.br/index.php/revistahuufma/article/view/14944/7868

Tran, H. M., Truong, V. T., Ngo, T. M. N., Bui, Q. P. V., Nguyen, H. C., Le, T. T. Q., Mazur, W., Chung, E., Cafardi, J. M., Pham, K. P. N., Duong, H. H. N., Nguyen, T., Nguyen, V. T., & Pham, V. N. (2017). Microbiological Profile and Risk Factors for in-Hospital Mortality of Infective Endocarditis in Tertiary Care Hospitals of South Vietnam. PLOS ONE, 12(12), e0189421. https://doi.org/10.1371/journal.pone.0189421

Van Dyke, T. E., & Sima, C. (2020). Understanding Resolution of Inflammation in Periodontal Diseases: Is Chronic Inflammatory Periodontitis a Failure to Resolve? Periodontology 2000, 82(1), 205–213. https://doi.org/10.1111/prd.12317

Veve, M. P., McCurry, E. D., Cooksey, G. E., & Shorman, M. A. (2020). Epidemiology and Outcomes of Non-HACEK Infective Endocarditis in the Southeast United States. PLOS ONE, 15(3), e0230199. https://doi.org/10.1371/journal.pone.0230199

Vieira Colombo, A. P., Magalhães, C. B., Hartenbach, F. A. R. R., Martins do Souto, R., & Maciel da Silva-Boghossian, C. (2016). Periodontal-Disease-Associated Biofilm: a Reservoir for Pathogens of Medical Importance. Microbial Pathogenesis, 94, 27–34. https://doi.org/10.1016/j.micpath.2015.09.009

Winkle, S. M., Gaballa, S., Memon, A., Miller, J. B., & Curfiss, R. (2020). Serratia Marcescens Tricuspid Valve Vegetation and Successful Use of the Angiovac® System. Cureus. https://doi.org/10.7759/cureus.10010

Published

14/03/2022

How to Cite

SILVA, P. C. P.; OLIVEIRA, I. A.; COSTA, C. M.; MATTOS, G. M. L. .; CÔRREA, N. de C.; CASANOVAS, R. C. Association between Periodontal Disease and Bacterial Endocarditis: case report. Research, Society and Development, [S. l.], v. 11, n. 4, p. e16311427186, 2022. DOI: 10.33448/rsd-v11i4.27186. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/27186. Acesso em: 19 apr. 2024.

Issue

Section

Health Sciences