An unusual case of dental infection by Pseudomonas aeruginosa causing a brain abscess: case report

Abstract

A brain abscess may result when dental infection reaches the brain through contiguous anatomic cavities such as the maxillary sinus, the ethmoid sinus and the orbital cavity. It is an important complication and should be treated aggressively. Such treatment would include the excision of the etiological factor, drainage and adjuvant antibiotic therapy. The present case concerns a 23 year old woman who presented at the General Hospital of Nova Iguaçu with complaints of pain in the right side of the face and was diagnosed with acute sinusitis. Antibiotics and analgesics were prescribed to treat the disease. However, after 10 days, she returned to the emergency room, presenting with proptosis of the right eyeball, subconjunctival haemorrhage, ophthalmoplegia and intense pain in the right orbit, in addition to headaches. After computed tomography was performed, she was diagnosed with a brain abscess in the frontal lobe with the involvement of the maxillary right first molar, the maxillary sinus, the ethmoid sinus and the orbital cavity. With culturing of the secretion, the growth of Pseudomonas aeruginosa colonies was evident. Treatment consisted of a craniotomy to drain the brain abscess, a Caldwell-Luc procedure to drain the right maxillary sinus, dental extraction and aggressive antibiotic therapy. After 6 weeks, the patient was discharged with no neurological sequelae.

Distinct Microbial Community of Accumulated Biofilm in Dental Unit Waterlines of Different Specialties

“…were detected in oral cavity of patients (Zuanazzi et al, 2010). There are several reports about these pathogens with related diseases, such as Pseudomonas aeruginosa with lung infection in patients suffering from cystic fibrosis (Schick and Kassen, 2018), or with brain abscess (Pereira et al, 2017). Some opportunistic fungal pathogens (e.g.…”

Cavernous sinus thrombosis followed by brain ischaemia in a type‐1 diabetic patient: a persistent endodontic infection report

“…Bacteria presenting in odontogenic infections can cause bacteraemia in distant places resulting in septicaemia. The infection propagation may occur by direct spreading through anatomical spaces (17) or by the haematogenous route. In the face, microorganisms reach the bloodstream through the facial vein taking its course by angular and ophthalmic vein until the cavernous sinus (4,5).…”

Treatment alternatives for the rehabilitation of the posterior edentulous maxilla

“…Subacute sinusitis typically manifests between 3 to 7 days after the surgical intervention. This complication is typically associated with severe suborbital pain and may lead to complete graft failure or secondary infections that can potentially spread beyond the antral cavity into the orbital region or even to the brain 72 . For that reason, effective and timely management of acute postoperative infections is crucial.…”