Septic pulmonary embolism is a rare condition, the common sources of which are bacterial endocarditis and infected venous catheters. Septic pulmonary embolism ascribed to dental infection is extremely rare. The present report describes a case of septic pulmonary embolism attributed to periapical periodontitis in a 39-year-old patient, who was admitted with persistent toothache, fever, and chest pain. Chest CT showed a feeding vessel sign and a target sign. A panoramic radiograph of the left maxillary bone showed alveolar bone loss in a horizontal pattern typical of periodontitis and periapical periodontitis. The patient was treated with intravenous antibiotics and teeth extraction. To our knowledge, only 4 cases of septic pulmonary embolism ascribed to dental infection have been reported in the English literature. These patients repeatedly developed dental infections but did not receive appropriate dental treatment including extraction of the causative teeth, leading to the development of septic pulmonary embolism. This paper may contribute to the limited clinical knowledge base regarding septic pulmonary embolism ascribed to periapical periodontitis. Effective oral care and removal of the primary source of infection, including extraction of the causative teeth, are important to prevent septic pulmonary embolism.

BACKGROUND: Specific IgE antibodies against the low-molecular-weight carbohydrate antigen that does not bridge IgE molecules on mast cells are not associated with clinical symptoms. Cross reactivity can be determined in allergen-specific IgE detection assays when the carbohydrate structures between pollen allergens and plant derived food allergens are similar; in such cases, false positive results for grain or legume allergens can be reported for pollen allergic patients who are not sensitized to those allergens. This phenomenon arises owing to the presence of cross-reactive carbohydrate determinants (CCDs). OBJECTIVE: This study aimed to assess the impact of CCD interference on the results for pollen allergen-specific IgE antibodies in the general adult population and to perform CCD inhibition tests evaluating the involvement of CCD on samples positive to pollen allergens. METHODS: Serum samples from 322 subjects were tested for IgE antibodies to pollens and CCD. The research subjects were given questionnaires about pollen allergic symptoms to help assess the presence of allergies. Allergen IgE antibodies for Japanese cedar, Japanese cypress, orchard grass, ragweed, MUXF, bromelain, horseradish peroxidase (HRP), and ascorbate oxidase (ASOD) were analyzed. RESULTS: It was observed that among individuals who tested positive to any of the pollen allergens, the positive ratio of CCD-specific IgE antibody was the highest for HRP (13.5%–50.0%). The results from the inhibition tests revealed that CCD was marginally present. Although IgE antibodies for cedar pollen did not react with CCD, IgE antibodies for Japanese cypress, orchard grass, and ragweed might be detected by the presence of CCD. CONCLUSION: The results of the inhibition tests revealed the obvious presence of CCD suggesting its involvement. Considering these findings, careful evaluation of patient IgE results should be performed for Japanese cypress, orchard grass, and ragweed.
Adult ; Allergens ; Ambrosia ; Antibodies ; Ascorbate Oxidase ; Asian Continental Ancestry Group ; Bromelains ; Cryptomeria ; Cupressus ; Dactylis ; Fabaceae ; False Positive Reactions ; Horseradish Peroxidase ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mast Cells ; Plants ; Pollen ; Research Subjects ; Rhinitis, Allergic ; Rhinitis, Allergic, Seasonal