Skip to main content
Top
Published in: Maxillofacial Plastic and Reconstructive Surgery 1/2019

Open Access 01-12-2019 | Metronidazole | Case report

Multiple brain abscesses treated by extraction of the maxillary molars with chronic apical lesion to remove the source of infection

Authors: Ki-Hyun Jung, Seong-Su Ro, Seong-Won Lee, Jae-Yoon Jeon, Chang-Joo Park, Kyung-Gyun Hwang

Published in: Maxillofacial Plastic and Reconstructive Surgery | Issue 1/2019

Login to get access

Abstract

Background

Brain abscess is a life-threatening condition that occurs due to complications during a neurosurgical procedure, direct cranial trauma, or the presence of local or distal infection. Infection in the oral cavity can also be considered a source of brain abscess.

Case presentation

A 45-year-old male patient was transported with brain abscess in the subcortical white matter. Navigation-guided abscess aspiration and drainage was performed in the right mid-frontal lobe, but the symptoms continued to worsen after the procedure. A panoramic radiograph showed alveolar bone resorption around the maxillary molars. The compromised maxillary molars were extracted under local anesthesia, and antibiotics were applied based on findings from bacterial culture. A brain MRI confirmed that the three brain abscesses in the frontal lobe were reduced in size, and the patient’s symptoms began to improve after the extractions.

Conclusion

This is a rare case report about multiple uncontrolled brain abscesses treated by removal of infection through the extraction of maxillary molars with odontogenic infection. Untreated odontogenic infection can also be considered a cause of brain abscess. Therefore, it is necessary to recognize the possibility that untreated odontogenic infection can lead to serious systemic inflammatory diseases such as brain abscess. Through a multidisciplinary approach to diagnosis and treatment, physicians should be encouraged to consider odontogenic infections as a potential cause of brain abscesses.
Literature
1.
go back to reference Morgan H, Wood MW, Murphey F (1973) Experience with 88 consecutive cases of brain abscess. J Neurosurg 38:698–704CrossRef Morgan H, Wood MW, Murphey F (1973) Experience with 88 consecutive cases of brain abscess. J Neurosurg 38:698–704CrossRef
2.
go back to reference Roche M, Humphreys H, Smyth E, Phillips J, Cunney R, McNamara E et al (2003) A twelve-year review of central nervous system bacterial abscesses; presentation and aetiology. Clin Microbiol Infect 9:803–809CrossRef Roche M, Humphreys H, Smyth E, Phillips J, Cunney R, McNamara E et al (2003) A twelve-year review of central nervous system bacterial abscesses; presentation and aetiology. Clin Microbiol Infect 9:803–809CrossRef
3.
go back to reference Yang SY (1981) Brain abscess: a review of 400 cases. J Neurosurg 55:794–799CrossRef Yang SY (1981) Brain abscess: a review of 400 cases. J Neurosurg 55:794–799CrossRef
4.
go back to reference Brouwer MC, van de Beek D (2017) Management of bacterial central nervous system infections. Handb Clin Neurol 140:349–364CrossRef Brouwer MC, van de Beek D (2017) Management of bacterial central nervous system infections. Handb Clin Neurol 140:349–364CrossRef
5.
go back to reference Dyke TE, Winkelhoff AJ (2013) Infection and inflammatory mechanisms. J Clin Periodontol 40:1–7CrossRef Dyke TE, Winkelhoff AJ (2013) Infection and inflammatory mechanisms. J Clin Periodontol 40:1–7CrossRef
6.
go back to reference Alvis Miranda H, Castellar-Leones SM, Elzain MA, Moscote-Salazar LR (2013) Brain abscess: current management. J Neurosci Rural Pract 4:67–81 Alvis Miranda H, Castellar-Leones SM, Elzain MA, Moscote-Salazar LR (2013) Brain abscess: current management. J Neurosci Rural Pract 4:67–81
7.
go back to reference Akashi M, Tanaka K, Kusumoto J, Furudoi S, Hosoda K, Komori T (2017) Brain abscess potentially resulting from odontogenic focus: report of three cases and a literature review. J Maxillofac Oral Surg 16:58–64CrossRef Akashi M, Tanaka K, Kusumoto J, Furudoi S, Hosoda K, Komori T (2017) Brain abscess potentially resulting from odontogenic focus: report of three cases and a literature review. J Maxillofac Oral Surg 16:58–64CrossRef
8.
go back to reference Limia A, Jimenez ML, Alarcon T (1999) Five-year analysis of antimicrobial susceptibility of the Streptococcus milleri group. Eur J Clin Microbiol Infect Dis 18:440–444CrossRef Limia A, Jimenez ML, Alarcon T (1999) Five-year analysis of antimicrobial susceptibility of the Streptococcus milleri group. Eur J Clin Microbiol Infect Dis 18:440–444CrossRef
Metadata
Title
Multiple brain abscesses treated by extraction of the maxillary molars with chronic apical lesion to remove the source of infection
Authors
Ki-Hyun Jung
Seong-Su Ro
Seong-Won Lee
Jae-Yoon Jeon
Chang-Joo Park
Kyung-Gyun Hwang
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
Maxillofacial Plastic and Reconstructive Surgery / Issue 1/2019
Electronic ISSN: 2288-8586
DOI
https://doi.org/10.1186/s40902-019-0208-2

Other articles of this Issue 1/2019

Maxillofacial Plastic and Reconstructive Surgery 1/2019 Go to the issue