Sepsis and septic shock caused by Porphyromonas gingivalis: a case report.

Background: Porphyromonas gingivalis is a predominant pathogen in periodontitis and is closely associated with the progression of chronic obstructive pulmonary disease (COPD).

Objective: This case report aims to describe a case of sepsis caused by P. gingivalis in a patient with COPD and a history of dental pain, highlighting the diagnostic challenges and clinical implications.

Design: This single case report was based on clinical data collected from medical records, with the pathogen identified from blood cultures by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). A comparative analysis was performed between the present case and previously reported cases of P. gingivalis bacteremia or sepsis based on a literature review. The patient was discharged after his general condition improved as a result of the potentially effective antimicrobial agents and anti-infective treatments through literature review.

Results: A 73-year-old man with COPD and a prolonged history of dental pain presented with a 30-year history of recurrent cough, expectoration, and dyspnoea, with symptoms exacerbating over the past 3 d and the recent onset of high fever for 1 d. Clinical evaluation revealed sepsis with rapid progression to septic shock. Blood cultures confirmed the presence of P. gingivalis.

Conclusions: This case highlights the need to consider anaerobes like P. gingivalis in septic patients with poor oral health, especially for patients with dental pain or periodontitis, and highlights the diagnostic challenges associated with slow-growing pathogens.