Brain abscesses and intracranial empyema due to dental pathogens: Case series. (2020)

• Record Type: Journal Article
• Authors: Kichenbrand, Charlène; Marchal, Alix; Mouraret, Alizée; Hasnaoui, Nasr; Guillet, Julie; Rech, Fabien; Phulpin, Berengère
• Is Part Of: International journal of surgery case reports. Volume 69(2020)
• Page Start: 35
• Page End: 38
• Publication Date: 2020
• Subjects: Brain abscess -- Intracranial empyema -- Oral infection -- Streptococci -- Odontogenic -- Teeth; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2020.03.025
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Cerebral infection is rare but life-threatening disease. Dental origin for brain abscesses or intra cranial empyema is very rarely reported in the literature. Infected maxillary teeth are probably involved in contiguous spread of the infection to the brain. There is currently no guidelines in oral surgery to manage patients with cerebral infection from dental origin. Abstract: Introduction: Spontaneous brain abscess and intracranial empyema are rare but life-threatening diseases. They can result from potential complications of oral chronic infections. Given the similarity between most of the germs commonly found both in cerebral abscess and in oral cavity and its anatomic proximity, the oral cavity represents a major source of cerebral infections. Presentation of cases: We report here a series of seven cases of intracranial abscesses and empyema due to dental pathogens that occurred in the neurosurgery department of our institute. Five of those seven cases were then cared in the oral surgery department of our institute. Discussion: Bacteriological examination of the brain abscesses identified an oral commensal bacterium belonging to streptococci group in six patients (85.7%) and Porphyromonas Gingivalis, a pathogen oral germ involved in periodontal diseases in the seventh patient. For all patients examined, oral status and oral health were poor or moderate with the presence of dental caries, missing teeth and abundant dental plaque. Except the oral cavity, no other front door or infectious site were found. Conclusion: This rare series of cases highlights the importance of systematically explore the oral cavity in presence of intracranial infection and to radically eradicate the potential infectious foci.