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

Antibiotic prophylaxis before invasive treatments, including dental extractions, is still recommended for patients at high risk of infective endocarditis. However, the risk from self-extraction of teeth in daily life of patients with intellectual disabilities is uncertain.

A 6-year-old patient with Ebstein's anomaly developed cerebral abscess, which appeared associated with infective endocarditis of dental origin. Two weeks after self-extraction of his deciduous teeth, he began to experience pain in his ear and developed continuous fever, followed by vomiting, facial spasm, and a loss of consciousness. He was admitted into a hospital for 2 months, during which he received intravenously administered antibiotics and a drainage tube in his brain.

Deciduous teeth can be self-extracted before root resorption and natural shedding in patients with intellectual disabilities. When they are at high risk of infective endocarditis and frequently touch mobile deciduous teeth, it seems to be an option to extract the teeth early with antibiotic prophylaxis, rather than to wait natural fall.