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Streptococcus Intermedius Brain and Diverticular Abscesses After Dental Manipulation: A Case Report
Hassan Al Moussawi1, Michael Krzyzak1, Zainab Awada1
1Department of Medicine, Staten Island University Hospital, Northwell Health.
Cureus
|March 17, 2018
Summary
Brain abscesses, often caused by bacteria like Streptococcus, can arise from dental procedures. This case shows how oral bacteria can lead to widespread infections, including brain abscesses, emphasizing the need for thorough screening.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Brain abscesses are life-threatening intracerebral infections, often caused by bacteria.
- Immunocompromised individuals and those with blood-brain barrier disruption are at higher risk.
- Common culprits include Streptococcus, Enterococcus, and Staphylococcus species.
Observation:
- Microorganisms invade the brain via direct spread (contiguous, odontogenic) or hematogenous spread.
- Dental procedures can lead to bacteremia and subsequent brain abscesses, though odontogenic origins are rare (approx. 5%).
- A case of brain and diverticular abscesses caused by Streptococcus intermedius following dental extraction is presented.
Findings:
- The case highlights that routine dental work can cause bacteremia and disseminated abscesses.
- Streptococcus intermedius, a member of the Streptococcus milleri group, was identified as the causative agent.
- Metastatic infection spread should be considered when S. milleri group organisms are diagnosed.
Implications:
- Physicians should screen for metastatic infection sites when S. milleri group bacteremia is diagnosed.
- This underscores the importance of considering dental origins in brain abscess cases.
- Early identification and treatment of bacteremia sources are crucial for preventing severe complications.
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