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Odontogenic (hematogenic) or sinusopathy (contiguous) brain abscess: Case report.

Claudine Thereza-Bussolaro¹, Eduarda B Ramos², Anna Ls Yanai³

¹School of Dentistry, University of Cuiabá, Cuiabá, MT, Brazil.

Journal of Clinical and Experimental Dentistry

|September 2, 2024

Summary

A rare brain abscess in a young woman, potentially linked to dental issues and sinusitis, highlights diagnostic challenges. Prompt intervention for preceding infections is crucial for managing this complex condition.

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Area of Science:

Neurology
Infectious Diseases
Oral Medicine

Background:

Brain abscess is a rare but serious condition with varied origins, including contiguous spread, hematogenous seeding, or trauma.
Dental infections are an atypical source, with Gemella morbillorum and odontogenic sinusitis typically presenting unilaterally.

Observation:

This case details a young, immunocompetent woman with a brain abscess caused by multidrug-resistant Streptococcus sanguis.
Computed tomography revealed sinusitis, and cultures identified Gemella morbillorum in the maxillary sinus.

Findings:

The patient underwent stereotactic drainage, sinusotomy, and prolonged antibiotics, requiring reintervention due to recurrence.
Treatment also included dental extraction and brain cyst capsule removal.

Implications:

Pinpointing the primary source of brain abscesses remains challenging despite advanced diagnostics.
Multidisciplinary care and prompt management of preceding infections like sinusitis and dental focal infections are vital for optimal patient outcomes.