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Pulmonary Aggregatibacter actinomycetemcomitans infection masquerades as malignancy in a patient with periodontitis
  1. Emma Turner1,
  2. Thomas Hastie1 and
  3. Pritam Daniel Sundaresan1,2
  1. 1Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
  2. 2Maxillofacial & Dental Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  1. Correspondence to Dr Pritam Daniel Sundaresan; Daniel.Sundaresan{at}health.wa.gov.au

Abstract

A 49-year-old man with a 37.5 pack-year smoking history presented with a suspected neoplasm of the right lung following the discovery of a metabolically active mass on positron emission tomography-CT imaging. The patient, who demonstrated poor oral hygiene, had a history of irregular problem-oriented dental visitation. Having excluded malignancy through histologic investigations, Aggregatibacter actinomycetemcomitans—a well-established periodontal pathogen—was subsequently cultured from his pulmonary aspirate. The patient was therefore managed with systemic antimicrobials and adjunctive dental extractions to eliminate the likely source of infection, whereafter the mass resolved without complication. This case corroborates previous reports of extraoral isolation of A. actinomycetemcomitans, which may mimic cancer clinically and radiographically. While a definitive causative link between untreated periodontitis and systemic infection remains to be elucidated, such cases present a compelling argument in favour of promoting oral health to prevent systemic disease.

  • dentistry and oral medicine
  • TB and other respiratory infections

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Footnotes

  • Contributors Supervised by PDS. Patient was under the care of PDS. ET and TH were involved with treatment planning and provided treatment. ET and TH wrote the manuscript in consultation with PDS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.