Association between periodontal disease and septicemia due to pyogenic hepatic abscess

Abstract

Case of a 65 year-old man with type-2 diabetes mellitus for<br />15 years who complained of abdominal pain in the right upper<br />quadrant associated with unquantified fever and weight loss<br />over a period of 25 days. In the emergency room, he presented<br />tachycardia, tachypnea and fever of 37 º C, diffuse abdominal<br />pain from light palpation without peritoneal irritation or<br />right upper quadrant tenderness upon fist percussion test.<br />Within a few hours the patient evolved to septic shock and<br />required transfer to the intermediate care unit. The abdominal<br />computerized axial tomography showed multiloculated<br />hepatic abscess. Percutaneous drainage was performed with<br />the culture positive for Escherichia coli and Fusobacterium<br />spp. Then, the differential diagnosis was made between<br />pyogenic or amebic liver abscess. Subsequently, oral cavity<br />examination revealed severe periodontal disease with coronal<br />destruction; therefore, extraction was scheduled.