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Brain Abscess Due to Dental Sinusitis: A Case Report on Incomplete Infection Defense Associated With a Post-Fusion
Shinya Watanabe1,2, Yasushi Shibata3,2, Eiichi Ishikawa2
1Department of Neurosurgery, Mito Kyodo General Hospital, Tsukuba University Hospital Mito Area Medical Education Center, Mito, JPN.
A brain abscess developed from dental sinusitis despite a healed skull fracture, highlighting the importance of treating dental and sinus infections promptly for complete infection defense.
Area of Science:
- Neurology
- Infectious Diseases
- Otolaryngology
Background:
- Brain abscesses are serious infections requiring early detection and treatment.
- Dental sinusitis can lead to brain abscesses, even with prior skull fractures.
Observation:
- A patient presented with headache and frontal sinusitis, initially treated with antibiotics.
- Refractory symptoms led to MRI revealing a large frontal lobe brain abscess adjacent to the frontal sinus.
Findings:
- Surgical drainage and cultures identified nasal commensal bacteria, indicating direct spread from sinusitis.
- An untreated infected tooth with maxillary sinus wall erosion was extracted.
- The patient recovered after eight weeks of antimicrobial therapy.
Implications:
- Healed skull fractures do not guarantee complete infection defense against contiguous spread.
- Prompt evaluation and treatment of dental and sinus infections, including imaging, are critical to prevent brain abscess formation.
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