<i>Streptococcus oralis</i> Meningitis with Gingival Bleeding in a Patient: A Case Report and Review of the Literature

Abstract

An 81-year-old man with a history of gingival bleeding presented with a fever, headache, and drowsiness. His mouth and full dentures were unsanitary. Laboratory tests revealed Streptococcus oralis meningitis caused by odontogenic bacteremia. We reviewed eight reported cases, including the present case, because S. oralis meningitis is rare. Our review indicated that S. oralis meningitis needs to be considered when encountering cases of a fever, disturbance of consciousness, and headache with episodes of possible odontogenic bacteremia.

Streptococcus oralis Meningitis

“…However, in a third of such meningitis cases, the exact source of infection is not clear [3] . To our knowledge, this is the ninth reported case of S. oralis meningitis [2] and the first seen in Portugal. Although S. oralis is believed to be a rare cause of meningitis, it should be considered in the differential diagnosis of meningitis in alcoholic patients with poor oral hygiene.…”

“…Dental caries and periodontal disease should be treated as most cases of streptococcal endocarditis are caused by poor oral hygiene rather than by dental procedures [5] . However, it is unclear if good oral hygienic can prevent S. oralis meningitis as so few cases have been reported [2] . Poor oral hygiene and dental treatment have a considerable role in S. oralis bacteraemia and in endocarditis [2] .…”

“…However, it is unclear if good oral hygienic can prevent S. oralis meningitis as so few cases have been reported [2] . Poor oral hygiene and dental treatment have a considerable role in S. oralis bacteraemia and in endocarditis [2] . In our opinion, despite the patient's blood culture being negative, and assuming that the mechanism is similar, the poor oral hygiene was the probable cause of meningitis in this patient.…”

“…Streptococcus oralis, a member of the Streptococcus mitis family, belongs to the viridans group and is part of the normal flora of the oropharyngeal, nasal, gastrointestinal and genitourinary tracts [1] . Classically, it shows low pathogenicity and virulence but is an important cause of subacute bacterial endocarditis [2] . Although viridans streptococcus often causes bacteriaemia [3] and can occur as a pathogenic microorganism in immunocompromised patients [4] , its association with meningitis is uncommon; the viridans streptococci (including S. oralis) account for only 0.3-2.4% of all causes of meningitis [3] .…”

Ill Effects and Complications Associated to Removable Dentures With Improper Use and Poor Oral Hygiene: A Systematic Review

“…The patient’s blood culture revealed Streptococcus oralis indicating a possible path of infection that could lead to odontogenic bacteremia. Poor oral hygiene resulted in gingival bleeding, leading to S. oralis meningitis [ 18 ].…”