Streptococcus sanguinis Brain Abscess as Complication of Subclinical Endocarditis: Emphasizing the Importance of Prompt Diagnosis

Abstract

A 19-year-old male patient was diagnosed with S. sanguinis brain abscess of unknown etiopathology as a complication of subclinical endocarditis. While viridans streptococci are implicated in dental seeding to the heart, S. sanguinis brain abscesses are rare. Six previous cases of S. sanguinis brain abscess in the literature reported dental procedures and maxillofacial trauma. In our patient, there was no obvious source of infective endocarditis preceding the development of brain abscess. This demonstrates the importance of prompt diagnosis and initiation of antimicrobial therapy given the potential for long-term sequelae such as focal deficits and seizures.

Critical role for the AIM2 inflammasome during acute CNS bacterial infection

“…Brain abscesses can originate from many sources, including: (i) subacute or chronic otitis media, mastoiditis, frontal or ethmoid sinusitis, or dental infection; (ii) hematogenous dissemination from peripheral sites of infection, including bacterial endocarditis or lung abscesses (Madsen ; Kassis et al . ; Wadhwa et al . ); (iii) immunocompromised patients with HIV infection, organ transplantation, chemotherapy, or steroid usage (Young and McGwire ; Muzumdar et al .…”

“…Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a frequent cause of hospitaland community-associated infections, which complicates treatment (Drago et al 2007) and MRSA isolates have been recovered from brain abscesses (Sifri et al 2007;Naesens et al 2009;Arora et al 2012;David et al 2012). Brain abscesses can originate from many sources, including: (i) subacute or chronic otitis media, mastoiditis, frontal or ethmoid sinusitis, or dental infection; (ii) hematogenous dissemination from peripheral sites of infection, including bacterial endocarditis or lung abscesses (Madsen 1983;Kassis et al 2010;Wadhwa et al 2012); (iii) immunocompromised patients with HIV infection, organ transplantation, chemotherapy, or steroid usage (Young and McGwire 2005;Muzumdar et al 2011);(iv) penetrating trauma to the calvarium; or (v) infectious complications following neurosurgical procedures. Without timely treatment intervention, a brain abscess can rupture, which is associated with a high mortality rate.…”

Multiple Streptococcus sanguinis brain abscesses misdiagnosed as cerebral manifestation of tuberculosis

“…Central nervous system infectiondue to S. sanguinis has rarely been reported in the literature. Facilitating conditions included infective endocarditis, pulmonary arteriovenous fistulas, and history of craniotomy in previously reported cases [1][2][3] ; however, neither foci of infection nor facilitating causes were found in the present case.…”

Cerebral abscess following the self-extraction of teeth in patient with Ebstein’s anomaly: a case report

“…The brain abscess in the present case seemed to develop as a result of hematogenous spread from the heart infected via the socket of extracted teeth. In fact, some brain abscesses were reported to be caused by dental-related IE [10]. Furthermore, the Streptococcus milleri group was found in both the patient’s blood and the culture obtained from drainage of the brain abscess.…”