Background
This case report highlights the rare association among a dental procedure, infective endocarditis, and an acute ischemic stroke.
Case Description
A 54-year-old woman who experienced an acute ischemic stroke 5 weeks after a tooth extraction is described. The initial symptoms of this patient included mild to moderate word-finding difficulty and right facial droop. Computed tomographic angiography revealed a left M1 segment middle cerebral artery occlusion (thrombolysis in cerebral infarction scale, 0) with reconstitution of the distal middle cerebral branches through arterial collaterals. After initial administration of tissue plasminogen activator, endovascular thrombectomy was successfully performed with thrombolysis in cerebral infarction scale 3 (complete) recanalization. After the procedure, the patient showed improvement in language and neurologic deficits. Imaging showed multifocal, bilateral, cortical, and deep brain hemorrhages. Blood cultures grew Streptococcus mitis, ultimately leading to the diagnosis of endocarditis. Echocardiographic imaging revealed moderate to severe aortic insufficiency, a mitral valve vegetation, and mild mitral valve regurgitation. After evaluation by the cardiothoracic surgery team, the patient was discharged with intravenous antibiotics and short-term outpatient follow-up with the cardiothoracic surgery team.
Practical Implications
Dental procedures, although generally safe, can introduce oral bacteria into the bloodstream, leading to bacterial seeding of cardiac valves and subsequent infective endocarditis. Recognizing infective endocarditis subsequent to a dental procedure, including a tooth extraction, as a potential cause of an acute ischemic stroke is vital so that prompt treatment can be initiated.
Authors: Momodou G. Bah, BSc, Zachary M. Wilseck, MD, Leanne Y. Lin, MD, MPHS, Andrew J. Peterson, DDS, Neeraj Chaudhary, MD, Joseph J. Gemmete, MD
Source: https://jada.ada.org/article/S0002-8177(23)00686-4/abstract
“I’m a dental assistant and I thought there could be a better way to retract the cheek or tongue without the hassle of the cotton rolling or slipping out of place,” said an InventHelp inventor...
Oral Hygiene & Prevention 01 August 2023
Dental tourism: could flying after treatment create problems?
Millions of people travel every year for health care and, mainly, they do it to obtain therapies at a lower cost than in the country of origin.
Biolase recently announced its first-quarter financial results. The company reported increased international laser sales by 22% year over year. In addition Biolase said that it had a record quarter...
Anderson is currently the solo practitioner in his dental practice. He has 12 people on his dental team, and they make the practice run, he said. The team...
Oral Hygiene & Prevention 06 February 2023
Quantifying the risk of prosthetic joint infections after invasive dental procedures
The authors aimed to identify any association between invasive dental procedures and late periprosthetic joint infections and whether antibiotic prophylaxis reduces LPJI incidence after IDPs.
Endodontics 03 December 2024
In Endodontics, a complete chemo-mechanical cleansing of the root canal system is essential to achieving success, which is gained through adequate tridimensional obturation of the endodontic space.
Digital Dentistry 30 November 2024
This paper presents an automated system for NC tool-path planning and generation of digital dental restoration
Digital Dentistry 29 November 2024
Early in 1980, the author anticipated the attraction of restoring posterior teeth with tooth-colored material.
Editorials 29 November 2024
The only time Hadren Simmons left Newark, where he was born and raised, was to serve his country. He enlisted in the Army right after his high school graduation.
Products 29 November 2024
Joshua Rubin, DDS, and Richard Ricci, DDS, discuss some of the impacts of artificial intelligence on the dental industry.