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Streptococcus intermedius causing primary bacterial ventriculitis in a patient with severe periodontitis - a case
Satu Allonen1, Janne Aittoniemi2, Matti Vuorialho3
1Mehiläinen, Tammisaari, Finland.
BMC Neurology
|April 5, 2024
Summary
Poor dental health can cause serious Streptococcus intermedius infections in the brain, leading to ventriculitis. This case highlights the importance of oral hygiene in preventing life-threatening central nervous system infections.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Streptococcus intermedius, part of the oral microbiota, can cause pyogenic infections.
- While known to cause brain abscesses and meningitis, ventriculitis from periodontitis is previously unreported.
Observation:
- A 64-year-old male presented with neurological symptoms including headache, fever, and imbalance.
- Initial meningitis treatment and diagnostics were inconclusive; condition worsened, revealing ventriculitis and hydrocephalus via MRI/CT.
- Advanced periodontal disease with abscesses was identified as the likely source.
Findings:
- Streptococcus intermedius was detected via PCR in cerebrospinal fluid (CSF) despite negative cultures.
- Gram-positive cocci were observed in CSF Gram staining.
- Advanced periodontal destruction and periapical abscesses were the probable origin of infection.
Implications:
- This case underscores the link between poor dental health and severe central nervous system infections.
- Primary bacterial ventriculitis presents diagnostic challenges, potentially delaying treatment and increasing mortality.
- Maintaining oral health is crucial for preventing potentially fatal infections.
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