ABSTRACT
The detection of infective endocarditis (IE) of oral origin has been previously discussed. However, there are few reports confirming this infection using molecular biological techniques. We herein describe the case of a 67-year-old man who developed IE. Blood culture samples and strains obtained from the gingival and buccal mucosa showed 100% identity to Enterococcus faecalis JCM 5803 on sequencing of 16S rRNA gene fragments. A random amplification of polymorphic DNA (RAPD) analysis showed the same pattern for these samples, thus confirming the identity of E. faecalis isolates in the blood and oral mucosa. Our observations provide novel information regarding the level of identity between IE pathogens and oral bacteria.
Subject(s)
Aortic Valve/pathology , Endocarditis, Bacterial/diagnosis , Enterococcus faecalis/isolation & purification , Heart Valve Prosthesis Implantation , Mouth Mucosa/microbiology , Pacemaker, Artificial/microbiology , Transcatheter Aortic Valve Replacement/methods , Aged , Aortic Valve/surgery , Colony-Forming Units Assay , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/microbiology , Humans , Male , RNA, Ribosomal, 16S/genetics , Random Amplified Polymorphic DNA Technique , Sensitivity and Specificity , Treatment OutcomeABSTRACT
We encountered a 74-year-old male patient with tongue laceration after convulsive seizures under intensive care. The tongue showed severe swelling, and the right ventral surface had been lacerated by his isolated and pointed right lower canine. Our university hospital has established a perioperative management center, and is promoting interprofessional collaboration, including dentists, in perioperative management. Dentists collaborating in the perioperative management center took dental impressions, with the support of anesthesiologists who opened the patient's jaw under propofol sedation, to produce a mouth protector. By raising the patient's bite, the completed mouth protector prevented the isolated tooth from contacting the tongue and protected the lacerated wound. Use of the mouth protector prevented the lacerated tongue from coming into contact with the pointed tooth, and the tongue healed gradually. These findings underscore that interprofessional collaboration including dentists can improve the quality of medical care.
