Dental extraction-associated cerebral abscess caused by Parvimonas micra

Dental extraction-associated cerebral abscesses are rare. To date, Parvimonas micra has not been reported as the causative organism of such abscesses.

A 66-year-old male presented with generalized seizures 12 days after molar extraction. He had been diagnosed with periodontitis 4 years earlier. Following the extraction, he was prophylactically administered clarithromycin for 1 week. At presentation, he exhibited left hemiparesis and dysarthria, with a body temperature of 38.0℃. Blood tests revealed mild elevations in white blood cell count and serum C-reactive protein levels. Echocardiography revealed no abnormalities. Cerebral magnetic resonance imaging demonstrated a cystic mass in the right frontal lobe, accompanied by rim-like enhancement and extensive perilesional edema, as well as hyperintensity on a diffusion-weighted sequence. The patient underwent burr-hole drainage, which yielded purulent discharge. Culture of the pus isolated P. micra and Fusobacterium nucleatum.

Cerebral abscesses may develop following dental extraction, and careful observation is required afterward. Early onset of neurological symptoms after dental extraction should raise suspicion of a cerebral abscess requiring timely surgical intervention.