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A Case of Infective Endocarditis Due to Oral Streptococci After Perioperative Oral Function Management
Masanori Nashi1, Shinsuke Yamamoto1, Keigo Maeda1
1Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, JPN.
Abstract:
Infective endocarditis is an extremely serious disease that can present with a variety of clinical manifestations, including infection of valves and endocardium, in patients with cardiac disease, and is associated with risk factors such as invasive dental procedures, caries, and periodontal disease. On the other hand, it has been shown that perioperative oral function management before various surgeries, such as those for malignant tumors, cardiovascular disease, and transplantation, may prevent or reduce postoperative complications. Close coordination between the dentist and cardiac surgeon is especially necessary before heart valve surgery because of the risk of severe complications. The number of perioperative oral management procedures being performed in community dental clinics is increasing. In the absence of clear guidelines, the physician-in-charge usually determines how to best perform oral management while considering the patient's needs. We report a case of infective endocarditis occurring after perioperative oral management in a young patient with good oral hygiene. This case shows that standardization of the techniques and widespread dissemination of the guidelines are required. Patients should be counseled regarding the importance of maintaining oral hygiene from a young age. This case report should act as a cautionary tale not only for hospital clinicians but also for community medical and dental practitioners, as the number of such patients is expected to increase in the future.
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