Brain Abscess: A Rare Clinical Case with Oral Etiology

Pereira, André; Tavares, Alcina; Prates, Marcelo; Ribeiro, Natacha; Fonseca, Lino; Marques, Mateus; Proença, Francisco

doi:10.1155/2022/5140259

Cited by 11 publications

(17 citation statements)

References 40 publications

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“…Several studies have demonstrated the involvement of bacteria of the oropharyngeal flora in the pathophysiology of many systemic, cardiovascular and cerebral diseases [3, 8]. Dental infection, and particularly periodontitis and dental caries are a rare but possible starting point for brain abscesses through haematogenous spread [1–6, 8, 11–14].…”

Section: Discussionmentioning

confidence: 99%

Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report

LAARIF

Schils

Lifrange

et al. 2023

Access Microbiology

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Introduction. Brain abscess is the most common focal infectious neurological injury. Until the nineteenth century this condition was fatal, however the development of neuroimaging for early diagnosis, neurosurgery and antibiotic therapy in the twentieth century has led to new therapeutic strategies decreasing mortality from 50 % in the 1970s to less than 10 % nowadays. In this context we report a case of brain abscess with a dental origin. Case report. A immunocompetent man without any addiction presented to the emergency department with dysarthria and frontal headache at home. The clinical examination was normal. Further investigations revealed a polymicrobial brain abscess as a consequence of an ear, nose or throat (ENT) infection with locoregional extension with a dental starting point involving Actinomyces israelii and Fusobacterium nucleatum . In spite of a rapid diagnosis and a neurosurgical management associated with an optimal treatment by a dual therapy made of ceftriaxone and metronidazole the patient unfortunately died. Conclusion. This case report shows that despite a low incidence and a good prognosis following the diagnosis, brain abscesses can lead to patient’s death. Thereby, when the patient’s condition and urgency allow, a thorough dental examination of patients with neurological signs following the recommendations would improve the diagnosis made by the clinician. The use of microbiological documentation, the respect of pre-analytical conditions, the interaction between the laboratory and the clinicians are indispensable for an optimal management of these pathologies.

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Section: Discussionmentioning

confidence: 99%

Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report

LAARIF

Schils

Lifrange

et al. 2023

Access Microbiology

View full text Add to dashboard Cite

show abstract

“…The odontogenic abscess also represents a source of spread especially through a hematogenous route, though this is exceedingly rare and is usually a diagnosis of exclusion. [ 1 , 11 ] However, the location of brain abscess near a traumatic fracture with dural violation raises suspicion for association of this orbital fracture caused by blunt trauma with intracranial abscess. A careful review of a patient’s history and risk factors is necessary to determine the source of infection and adequate treatment, whether the infection be traumatic, iatrogenic, or otherwise.…”

Section: Discussionmentioning

confidence: 99%

Development of posttraumatic frontal brain abscess in association with an orbital roof fracture and odontogenic abscess: A case report

Abdulrazeq

Walek

Sampath

et al. 2022

Surgical Neurology International

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Background: Brain abscess is a potentially fatal condition. Orbital fractures caused by penetrating injury may be associated with intracranial infection. Such complication associated with blunt trauma, orbital roof fractures, and odontogenic abscesses is exceedingly rare. Case Description: We report the case of a 40-year-old transgender female with a frontal abscess presenting several weeks following a motor vehicle crash from which she suffered multiple facial fractures and an odontogenic abscess. On computed tomography scan, the patient had multiple right-sided facial fractures, including a medial orbital wall fracture and a right sphenoid fracture extending into the superior orbital roof. There was hemorrhage notable in the right frontal lobe. Communication with the ethmoid sinuses likely provided a conduit for bacterial spread through the orbit and into the intracranial and subdural spaces. Conclusion: Skull base fractures that communicate with a sinus, whether it be frontal, ethmoid, or sphenoid may increase the risk of brain abscess, especially in patients who develop an odontogenic abscess. Surgical repair of the defect is essential, and treating patients prophylactically with antibiotics may be beneficial.

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“…Unlike other strict anaerobic bacteria, F. nucleatum possess NADH oxidase endowing them with a limited ability to survive in oxygenated environment [ 117 ]. In addition to its implication in periodontal disease [ 118 ], F. nucleatum is capable of systemic dissemination and causing extra-oral infections, such as brain, liver, spleen, and lung abscesses, septicemia related infections, pelvic inflammatory disease, and intrauterine infections [ 119 , 120 , 121 , 122 , 123 , 124 ]. F. nucleatum is equipped with a variety of adhesins that enable it to adhere to various microorganisms.…”

Section: Virulence Factors Of Periodontal Pathogens and Their Associa...mentioning

confidence: 99%

Virulence Factors of the Periodontal Pathogens: Tools to Evade the Host Immune Response and Promote Carcinogenesis

2023

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Periodontitis is the most common chronic, inflammatory oral disease that affects more than half of the population in the United States. The disease leads to destruction of the tooth-supporting tissue called periodontium, which ultimately results in tooth loss if uncured. The interaction between the periodontal microbiota and the host immune cells result in the induction of a non-protective host immune response that triggers host tissue destruction. Certain pathogens have been implicated periodontal disease formation that is triggered by a plethora of virulence factors. There is a collective evidence on the impact of periodontal disease progression on systemic health. Of particular interest, the role of the virulence factors of the periodontal pathogens in facilitating the evasion of the host immune cells and promotion of carcinogenesis has been the focus of many researchers. The aim of this review is to examine the influence of the periodontal pathogens Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Fusobacterium nucleatum (F. nucleatum) in the modulation of the intracellular signaling pathways of the host cells in order to evade the host immune response and interfere with normal host cell death and the role of their virulence factors in this regard.

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Brain Abscess: A Rare Clinical Case with Oral Etiology

Cited by 11 publications

References 40 publications

Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report

Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report

Development of posttraumatic frontal brain abscess in association with an orbital roof fracture and odontogenic abscess: A case report

Virulence Factors of the Periodontal Pathogens: Tools to Evade the Host Immune Response and Promote Carcinogenesis

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