While some studies have found a similar association between oral bacterial flora and bacteriospermia and have suggested that oral pathogens can penetrate through the epithelial barrier and enter the circulatory system, leading to bacteremia and bacteriospermia,35 others have suggested that certain periodontal pathogens can indirectly contribute to increased serum levels of proinflammatory cytokines such as IFN-γ and TNF-α. Here, TNF is linked to bacterial infectious disease with sepsis.