Use of FDG-PET to detect a chronic odontogenic infection as a possible source of the brain abscess

Sato, Jun; Kuroshima, Takeshi; Wada, Mayumi; Satoh, Akira; Watanabe, Shirô; Okamoto, Susumu; Shiga, Tohru; Tamaki, Nagara; Kitagawa, Yoshimasa

doi:10.1007/s10266-015-0218-1

Cited by 9 publications

(6 citation statements)

References 10 publications

(30 reference statements)

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“…Although not specific to actinomycosis, imaging can show abnormalities such as cerebral and/or orbital abscess, meningitis and subdural/epidural empyema [4]. Interestingly, Sato et al recently described FDG-PET scan findings identifying an odontogenic infection as the cause of a brain abscess [24] Unfortunately, in our case no such findings were seen on the FDG-PET scan. Actinomycetes are extremely difficult to culture [5, 25].…”

Section: Discussionmentioning

confidence: 70%

Intracranial actinomycosis of odontogenic origin masquerading as auto-immune orbital myositis: a fatal case and review of the literature

et al. 2019

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Background Actinomycetes can rarely cause intracranial infection and may cause a variety of complications. We describe a fatal case of intracranial and intra-orbital actinomycosis of odontogenic origin with a unique presentation and route of dissemination. Also, we provide a review of the current literature. Case presentation A 58-year-old man presented with diplopia and progressive pain behind his left eye. Six weeks earlier he had undergone a dental extraction, followed by clindamycin treatment for a presumed maxillary infection. The diplopia responded to steroids but recurred after cessation. The diplopia was thought to result from myositis of the left medial rectus muscle, possibly related to a defect in the lamina papyracea. During exploration there was no abnormal tissue for biopsy. The medial wall was reconstructed and the myositis responded again to steroids. Within weeks a myositis on the right side occurred, with CT evidence of muscle swelling. Several months later he presented with right hemiparesis and dysarthria. Despite treatment the patient deteriorated, developed extensive intracranial hemorrhage, and died. Autopsy showed bacterial aggregates suggestive of actinomycotic meningoencephalitis with septic thromboembolism. Retrospectively, imaging studies showed abnormalities in the left infratemporal fossa and skull base and bilateral cavernous sinus. Conclusions In conclusion, intracranial actinomycosis is difficult to diagnose, with potentially fatal outcome. An accurate diagnosis can often only be established by means of histology and biopsy should be performed whenever feasible. This is the first report of actinomycotic orbital involvement of odontogenic origin, presenting initially as bilateral orbital myositis rather than as orbital abscess. Infection from the upper left jaw extended to the left infratemporal fossa, skull base and meninges and subsequently to the cavernous sinus and the orbits. Electronic supplementary material The online version of this article (10.1186/s12879-019-4408-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 70%

Intracranial actinomycosis of odontogenic origin masquerading as auto-immune orbital myositis: a fatal case and review of the literature

et al. 2019

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“…Oral periodontal abscess is an oral infective, painful disease that can spread (Yoneda et al, 2011; Herrera et al, 2014; Sato et al, 2016), and it is a valuable potential sign of undiagnosed type 2 diabetes (Alagl, 2017). Several studies have identified the dominant microbiota by culture-based diagnostic methods (Newman and Sims, 1979; Jaramillo et al, 2005; Xie et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Microbiota in Human Periodontal Abscess Revealed by 16S rDNA Sequencing

Chen

Zhu

et al. 2019

Front. Microbiol.

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Periodontal abscess is an oral infective disease caused by various kinds of bacteria. We aimed to characterize the microbiota composition of periodontal abscesses by metagenomic methods and compare it to that of the corresponding pocket and healthy gingival crevice to investigate the specific bacteria associated with this disease. Samples from abscess pus (AB), periodontal pocket coronally above the abscess (PO), and the gingival crevice of the periodontal healthy tooth were obtained from 20 periodontal abscess patients. Furthermore, healthy gingival crevice samples were obtained from 25 healthy individuals. Bacterial DNA was extracted and 16S rRNA gene fragments were sequenced to characterize the microbiota and determine taxonomic classification. The beta-diversity analysis results showed that the AB and PO groups had similar compositions. Porphyromonas gingivalis , Prevotella intermedia , and other Prevotella spp. were the predominant bacteria of human periodontal abscesses. The abundances of Filifactor alocis and Atopobium rimae were significantly higher in periodontal abscesses than in the periodontal pocket, suggesting their association with periodontal abscess formation. In conclusion, we characterized the microbiota in periodontal abscess and identified some species that are positively associated with this disease. This provides a better understanding of the components of periodontal abscesses, which will help facilitate the development of antibiotic therapy strategies.

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“…MR spectroscopy detects the products of bacterial metabolism (lactate, acetate, and succinate) and neutrophil proteolysis (cytosolic amino acids), which are used as support. It has even been reported that the combined use of DWI and MR spectroscopy increased the specificity and sensitivity to 95.2% and 100%, respectively [5 , 6] .…”

Section: Discussionmentioning

confidence: 99%

“…Abscess evacuation surgery without proper antibiotic coverage is less meaningful in handling. Brain abscesses are generally treated with antimicrobial therapy for a minimum of 4-8 weeks but longer for abscesses treated with medical therapy without surgical excision [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] . In this case, the patient experienced successful 28 weeks of adequate antibiotic therapy as seen on a contrast-enhanced head MRI showing resolution of the abscess diameter and clinical improvement of vertigo in the patient.…”

Section: Discussionmentioning

confidence: 99%

Outcome of medical treatment of otogenic brain abcess without therapeutic drainage: A case of central vertigo

Pribadi

Prasetio

Irsalina

et al. 2022

Radiology Case Reports

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Use of FDG-PET to detect a chronic odontogenic infection as a possible source of the brain abscess

Cited by 9 publications

References 10 publications

Intracranial actinomycosis of odontogenic origin masquerading as auto-immune orbital myositis: a fatal case and review of the literature

Intracranial actinomycosis of odontogenic origin masquerading as auto-immune orbital myositis: a fatal case and review of the literature

Microbiota in Human Periodontal Abscess Revealed by 16S rDNA Sequencing

Outcome of medical treatment of otogenic brain abcess without therapeutic drainage: A case of central vertigo

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