Open Access Open Access  Restricted Access Subscription or Fee Access

Infective Endocarditis, Result of Chronic Periodontal Disease: A Real And Present Danger

Ashadeep Kaushal, Kanwarjit Singh Asi, Ajay Mahajan, Vindeshwari Bhatia, Poonam Mahajan


Introduction: Endocarditis is an inflammation of the endocardium, the inner lining of the heart and heart valves. It is usually caused by bacteria and is associated with high mortality and morbidity. It can result from transient bacteremia from the oral cavity. Streptococci are the primary colonizers of tooth surface and are instrumental in development of the complex oral biofilm, dental plaque. Streptococcus sanguinis is one of the abundant oral commensals but can become pathogenic when given an opportunity.

 Case Presentation: During examination of a young female patient in the Department of Periodontology we came across a rare condition of Infective Endocarditis with ischemic infarct of brain also with poor periodontal health.

Conclusion: The symptoms like headache and intermittent fever without underlying dental and periodontal cause should not be overlooked as it might result in Infective Endocarditis. An early diagnosis is must to treat such life-threatening conditions to prevent further complications.


Infective endocarditis,Streptococcus sanguinis, ischemic infarct, periodontal therapy.

Full Text:



Lockhart B, Durack T. Oral microflora as a cause of endocarditis and other distant site infections. Infect Dis Clin North Am 1999;13(4):833-850.

Lockhart B, Brennan T, Thornhill M, et al . Poor oral hygiene as a risk factor for infective endocarditis–related bacteremia. J Am Dent Assoc J Am Dent Assoc. 2009;140(10):1238-1244.

Gao L, Xu T, Huang G, Jiang S, Gu Y, Chen F. Oral microbiomes: more and more importance in oral cavity and whole body. Protein Cell. 2018;9(5):488-500.

Martini M, Moricz S, Ripperger K, et al. Association of novel Streptococcus sanguinis virulence factors with pathogenesis in a native valve infective endocarditis model. Front. microbiol. 2020;11:10-13.

Lockhart B, Brennan T, Sasser C, Fox C, Paster J, Bahrani-Mougeot K. Bacteremia associated with tooth brushing and dental extraction. Circulation. 2008;117(24):3118-120.

Silver G, Martin W, McBride C. Experimental transient bacteraemias in human subjects with varying degrees of plaque accumulation and gingival inflammation. J Clin Periodontol. 1977;4(2):92-99

Horaud T, Delbos F. Viridans streptococci in infective endocarditis: species distribution and susceptibility to antibiotics. Eur. Heart J. 1984;5Suppl C:39–44.

Brinkman L, Patel R. Molecular pathogenesis of infective endocarditis. Mol. Med.Micrbiol.2015;1:811-822. Academic Press.

Herzberg C, MacFarlane D, Gong E, et al. The platelet interactivity phenotype of Streptococcus sanguis influences the course of experimental endocarditis. Infect Immun. 1992;60(11):4809-4818

Tomas I, Alvarez M. History of antimicrobial prophylaxis protocols for infective endocarditis secondary to dental procedures. In: Kerrigan SW, editor. Recent advances in infective endocarditis. Croacia: InTech. 2013;2:53–84.

Zeng S, Lin Y, Tu K, et al. Prevention of postdental procedure bacteremia: A network meta-analysis. J Dent Res. 2019;98(11):1204-1210.

Jeske H. Highlights of updated recommendations by the American Heart Association (AHA) for the prevention of bacterial endocarditis. Tex Dent J. 1997;114(7):15–16.

Gould K, Elliott S, Foweraker J, et al. Guidelines for the prevention of endocarditis: report of the Working Party of the British Society for Antimicrobial Chemotherapy. J AntimicrobChemother. 2006; 57(6):1035–1042.

Horliana C, Chambrone L, Foz M, et al. Dissemination of periodontal pathogens in the bloodstream after periodontal procedures: a systematic review. PLoS One. 2014 ;9(5):e98271.


  • There are currently no refbacks.

Copyright (c) 2022 Research & Reviews: A Journal of Dentistry