PMC6942721_01
Plain X-ray and CT image. Reticular shadow with ground-glass opacity was observed in the medial lobe of the right lung in the plain X-ray (a) and CT (c) on abnormalities disappeared 45 days later (b).
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Plain X-ray and computed tomography (CT) images are shown in Figure 1. Additionally, the patient ceased expressing pain vocally and through facial expression during POHC, and the redness of the oral mucosa totally disappeared (Figures 2 and 3, Table 1). The X-ray abnormality and his consciousness (JCS: I-3) also improved (Figures 1(b) and 2).
Time course of body temperature (BT) and C-reactive protein (CRP). BT and CRP are indicated by red closed circles and a solid line and blue closed circles and a solid line, respectively. Detection of bacteria by sputum culture, administration of acetaminophen (APAP), and professional oral health care intervention are indicated by black, purple, and red arrows, respectively. Treatment durations of tazobactam/piperacillin (TAZ/PIPC) and garenoxacin (GNRX) are indicated by solid bars. Oral Health Assessment Tool (OHAT) scores, assessed by the patient's oral condition at each timepoint, are indicated by red colored and red underlined text in the upper part of the figure.
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MDRP was detected in his sputum culture (Figure 2) and the severity of the pneumonia increased (PSI: IV and A-DROP: 3). Because liver damage was then observed (aspartate transaminase (AST): 980 IU/L, alanine transaminase (ALT): 733 IU/L, and gamma-glutamyl transpeptidase (gamma-GTP): 99 IU/L), garenoxacin was discontinued (Figure 2). Additionally, the patient ceased expressing pain vocally and through facial expression during POHC, and the redness of the oral mucosa totally disappeared (Figures 2 and 3, Table 1).
Oral condition at (a) initial dental examination and (b) after receiving professional oral health care.
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He had only three remaining natural teeth, which were all missing their crowns (13, 21, and 23; Figure 3). Multiple membranous substances were found to be adhering to the surface of the tongue, palate, and buccal mucosa at the initial oral examination (Figure 3(a), Table 1, Oral Health Assessment Tool (OHAT) score: 13). Additionally, the patient ceased expressing pain vocally and through facial expression during POHC, and the redness of the oral mucosa totally disappeared (Figures 2 and 3, Table 1).