{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:53:17Z","timestamp":1791550397810,"version":"4.3.4"},"reference-count":32,"publisher":"Akademiai Kiado Zrt.","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["EUJMI"],"published-print":{"date-parts":[[2026,10,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Periodontal dysbiosis is characterized by a shift towards specific obligate anaerobic bacteria, capable of inducing persistent, low-grade systemic inflammation. Increasing evidence links oral anaerobes to increased vascular risk and neuroinflammatory pathways. We present the case of a 45-year-old, previously healthy, Caucasian male, enrolled as a control subject in a prospective clinical study, exhibiting poor oral hygiene, generalized gingival inflammation, bleeding on probing: 56.79%, plaque index: 85.18%, and a 7\u2009mm periodontal pocket. Anaerobic culture from subgingival plaque sampling revealed the presence of\n                    <jats:italic>Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella buccae, Veillonella parvula<\/jats:italic>\n                    and\n                    <jats:italic>Veillonella rogosae (V. rogosae)<\/jats:italic>\n                    . Concurrently, elevated serum high-sensitivity C-reactive protein (hsCRP) (6.3\u2009mg L\n                    <jats:sup>\u22121<\/jats:sup>\n                    ) was also detected. Prior to scheduled follow-up, the patient developed a\u00a0spontaneous subarachnoid hemorrhage, where neuroimaging and angiography did not identify a vascular source. After recovery, periodontal therapy and cessation of all tobacco products, subgingival anaerobic diversity markedly decreased, with persistent detection of\n                    <jats:italic>V. rogosae<\/jats:italic>\n                    only; in addition, hsCRP also normalized. Although causality cannot be established, our case highlights systemic inflammatory implications of periodontal dysbiosis \u2013 and underlying neuroinflammatory processes \u2013 and demonstrates\u00a0that periodontal therapy may be crucial in normalizing systemic inflammatory markers, effectively contributing a decreased disease burden through multiple pathways.\n                  <\/jats:p>","DOI":"10.1556\/1886.2026.00047","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:16:22Z","timestamp":1791548182000},"update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["Periodontal dysbiosis in a healthy control subject later affected by subarachnoid hemorrhage: A\u00a0case report"],"prefix":"10.1556","author":[{"given":"L\u00eddia Petra","family":"Pasitka","sequence":"first","affiliation":[{"name":"Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of P\u00e9cs, 7623\u00a0P\u00e9cs, T\u00fcz\u00e9r str. 1., Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6149-9787","authenticated-orcid":true,"given":"Tiham\u00e9r","family":"Moln\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Neurocritical Care Unit, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Ifj\u00fas\u00e1g \u00fatja 13., Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1gnes","family":"B\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of P\u00e9cs, 7623\u00a0P\u00e9cs, T\u00fcz\u00e9r str. 1., Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tam\u00e1s","family":"Veisz","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of P\u00e9cs, 7623\u00a0P\u00e9cs, T\u00fcz\u00e9r str. 1., Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1ri\u00f3","family":"Gajd\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Public Health, Albert Szent-Gy\u00f6rgyi Medical School, University of Szeged, 6720\u00a0Szeged, D\u00f3m t\u00e9r 10., Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Cs\u00e9csei","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, R\u00e9t utca 2., Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edit","family":"Urb\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Szigeti \u00fat 12., Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"B1","series-title":"Front Microbiol","article-title":"Periodontitis: etiology, conventional treatments, and emerging bacteriophage and predatory bacteria therapies","volume":"15","author":"Lasica A","year":"2024","unstructured":"Lasica A, Golec P, Laskus A, Zalewska M, Gedaj M. Periodontitis: etiology, conventional treatments, and emerging bacteriophage and predatory bacteria therapies. Front Microbiol. 2024;15:e1469414."},{"key":"B2","series-title":"Lancet","first-page":"1809","article-title":"Periodontal diseases","volume":"366","author":"Pihlstrom BL","year":"2005","unstructured":"Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005;366:1809\u201320."},{"key":"B3","series-title":"Nat Rev Dis Primers","article-title":"Periodontal diseases","volume":"3","author":"Kinane DF","year":"2017","unstructured":"Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nat Rev Dis Primers. 2017;3:e17038."},{"key":"B4","series-title":"Nat Rev Immunol","first-page":"30","article-title":"Periodontitis: from microbial immune subversion to systemic inflammation","volume":"15","author":"Hajishengallis G","year":"2015","unstructured":"Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015;15:30\u201344."},{"key":"B5","series-title":"Mol Oral Microbiol","first-page":"117","article-title":"Assessing evidence to include Filifactor alocis as a novel candidate in Socransky's complexes","volume":"41","author":"Abdulkareem AA","year":"2026","unstructured":"Abdulkareem AA, Gul SS, Abdulbaqi HR, Sha AM, Preshaw PM. Assessing evidence to include Filifactor alocis as a novel candidate in Socransky's complexes. Mol Oral Microbiol. 2026;41:117\u201330."},{"key":"B6","series-title":"Mol Oral Microbiol","first-page":"12","article-title":"Filifactor alocis enhances survival of Porphyromonas gingivalis W83 in response to H2 O2 -induced stress","volume":"39","author":"Mishra A","year":"2024","unstructured":"Mishra A, Dou Y, Wang C, Fletcher HM. Filifactor alocis enhances survival of Porphyromonas gingivalis W83 in response to H2 O2 -induced stress. Mol Oral Microbiol. 2024;39:12\u201326."},{"key":"B7","series-title":"Front Microbiol","article-title":"Outer membrane vesicles of Porphyromonas gingivalis: recent advances in pathogenicity and associated mechanisms","volume":"16","author":"Wu Z","year":"2025","unstructured":"Wu Z, Long W, Yin Y, Tan B, Liu C, Li H, et\u00a0al. Outer membrane vesicles of Porphyromonas gingivalis: recent advances in pathogenicity and associated mechanisms. Front Microbiol. 2025;16:e1555868."},{"key":"B8","series-title":"Front Physiol","article-title":"Periodontal inflammation and systemic diseases: an overview","volume":"12","author":"Mart\u00ednez-Garc\u00eda M","year":"2021","unstructured":"Mart\u00ednez-Garc\u00eda M, Hern\u00e1ndez-Lemus E. Periodontal inflammation and systemic diseases: an overview. Front Physiol. 2021;12:e709438."},{"key":"B9","series-title":"J Clin Periodontol","first-page":"277","article-title":"A systematic review and meta-analysis on C-reactive protein in relation to periodontitis","volume":"35","author":"Paraskevas S","year":"2008","unstructured":"Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analysis on C-reactive protein in relation to periodontitis. J Clin Periodontol. 2008;35:277\u201390."},{"key":"B10","series-title":"J Clin Diagn Res","first-page":"ZE21","article-title":"C-Reactive Protein (CRP) and its association with periodontal disease: a brief review","volume":"8","year":"2014","unstructured":"C-Reactive Protein (CRP) and its association with periodontal disease: a brief review. J Clin Diagn Res. 2014;8:ZE21\u20134."},{"key":"B11","series-title":"J Periodontol","first-page":"465","article-title":"Periodontitis is associated with systemic inflammation and vascular endothelial dysfunction in patients with lacunar infarct","volume":"90","author":"Leira Y","year":"2019","unstructured":"Leira Y, Rodr\u00edguez-Y\u00e1nez M, Arias S, L\u00f3pez-Dequidt I, Campos F, Sobrino T, et\u00a0al. Periodontitis is associated with systemic inflammation and vascular endothelial dysfunction in patients with lacunar infarct. J Periodontol. 2019;90:465\u201374."},{"key":"B12","series-title":"Eur J Microbiol Immunol","first-page":"125","article-title":"Role of Actinomyces spp. and related organisms in the development of medication-related osteonecrosis of the jaw (MRONJ): clinical evidence based on a case series","volume":"13","author":"Zs K","year":"2023","unstructured":"Zs K, B\u00e1n \u00c1, Gajd\u00e1cs M, Polg\u00e1r B, Urb\u00e1n E. 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Lancet. 2025;405:897\u2013910."},{"key":"B14","series-title":"Front Oral Health","article-title":"Global, regional, and national burden of periodontal diseases from 1990 to 2021 and predictions to 2040: an analysis of the global burden of disease study 2021","volume":"6","author":"Hu M","year":"2025","unstructured":"Hu M, Zhang R, Wang R, Wang Y, Guo J. Global, regional, and national burden of periodontal diseases from 1990 to 2021 and predictions to 2040: an analysis of the global burden of disease study 2021. Front Oral Health. 2025;6:e1627746."},{"key":"B15","series-title":"Dent J","article-title":"Mapping review of the correlations between periodontitis, dental caries, and endocarditis","volume":"16","author":"Dioguardi M","year":"2025","unstructured":"Dioguardi M, Guerra C, Laterza P, Illuzzi G, Sovereto D, Laneve E, et\u00a0al. Mapping review of the correlations between periodontitis, dental caries, and endocarditis. Dent J. 2025;16:e215."},{"key":"B16","series-title":"J Pers Med","article-title":"The impact of periodontal disease on preterm birth and preeclampsia","volume":"14","author":"Tsikouras P","year":"2024","unstructured":"Tsikouras P, Okionomou E, Nikolettos K, Andreou S, Kyriakou D, Damaskos C, et\u00a0al. The impact of periodontal disease on preterm birth and preeclampsia. J Pers Med. 2024;14:e345."},{"key":"B17","series-title":"Lancet Neurol","first-page":"626","article-title":"Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis","volume":"10","author":"Vlak MH","year":"2011","unstructured":"Vlak MH, Algra A, Brandenburg R, Je Rinkel G. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. 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Acta Odontol Scand. 2016;74:315\u201320."},{"key":"B24","series-title":"Neurosurg Rev","first-page":"669","article-title":"Periodontitis and gingival bleeding associate with intracranial aneurysms and risk of aneurysmal subarachnoid hemorrhage","volume":"43","author":"Hallikainen J","year":"2019","unstructured":"Hallikainen J, Lindgren A, Savolainen J, Selander T, Jula A, Nahri M, et\u00a0al. Periodontitis and gingival bleeding associate with intracranial aneurysms and risk of aneurysmal subarachnoid hemorrhage. Neurosurg Rev. 2019;43:669\u201379."},{"key":"B25","series-title":"Acta Neurochir","first-page":"169","article-title":"Unlike severe periodontitis, caries does not associate with intracranial aneurysms or aneurysmal subarachnoid hemorrhage","volume":"165","author":"Hallikainen J","year":"2023","unstructured":"Hallikainen J, Pessi T, Vehkalahti M, Suominen AL, Pyysalo M, Fr\u00f6sen J. 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J Clin Periodontol. 2014;41:70\u20139."},{"key":"B32","series-title":"Biomedicines","first-page":"e48","article-title":"Periodontal bacteria and outcomes following aneurysmal subarachnoid\u00a0hemorrhage: a prospective observational analysis","volume":"14","author":"Pasitka LP","year":"2026","unstructured":"Pasitka LP, Moln\u00e1r T, Urb\u00e1n E, Cs\u00e9csei P, Hetesi Z, M\u00f3d J, et\u00a0al. Periodontal bacteria and outcomes following aneurysmal subarachnoid\u00a0hemorrhage: a prospective observational analysis. 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