Brain abscess of odontogenic origin in patients with malignant tumors: A report of two cases

Abstract

Background: Oral infection and dental manipulations can lead to the development of brain abscesses, a rare but potentially life-threatening condition. Herein, we report patients undergoing cancer treatment who developed brain abscesses of odontogenic origin at our hospital. Case Description: Two patients developed brain abscesses during cancer treatment. Both underwent neurosurgical aspiration, and the causative microorganism was identified as Streptococcus intermedius of the Streptococcus anginosus group, which is a part of the normal bacterial flora in the oral cavity. There was clinical and radiographic evidence of dental infection in one of the patients diagnosed with a brain abscess of odontogenic origin. No infectious foci were found in the other patient during hospitalization for the abscess. However, the patient had undergone extraction of an infected tooth approximately 3 months before admission for the abscess, suggesting origination from an oral infection or dental manipulation. The patients’ cancers rapidly worsened because cancer treatment in both patients was interrupted for several months to treat the brain abscess. Conclusion: Oral infections can cause severe infections, such as brain abscesses, particularly during the treatment of malignant tumors. Improving the oral environment or treating oral infections before initiating treatment for malignant tumors is highly recommended. In addition, the possibility of odontogenic origin should always be considered as a potential etiology of brain abscesses.

Potential infection foci in the oral cavity and their impact on the formation of central nervous system abscesses: A literature review

“…[11] Shibata et al reported the incidence of brain abscesses as 0.4 to 0.9 cases per 100,000 persons. [12] Brain abscesses can occur at any age, but most cases occur between the third and fifth decades of life, [13] and more often affecting males < 60 years old. [14] Additionally, 25% of all brain abscesses occur in children between 4 and 7 years old, often in multifocal locations (about 30% of cases).…”

Odontogenic brain abscess due to Anaerococcus prevotii infections: A case report and review article

“…To prove that an abscess has genuinely developed from odontogenic sources, 3 criteria should be met, including no alternative source of bacteremia is found, the bacteria responsible for the bump are typically found in the oral microflora, and clinical sign of the active dental disease is present [1] , [7] . Clinically, there is usually a latent period of several days or weeks before symptoms of intracranial involvement appear.…”

“…Brain Abscess, a focal pyogenic of the brain, can be caused by bacteria, mycobacteria, fungi or parasites (protozoa and helminths) [1] , [2] . Various symptoms and signs depend on the abscess's number, location, and site [3] .…”

Dental Infections and Risk for Brain Abscess: A Literature Review

“…abscess is helpful as it can prevent the infection from spreading to nearby tissue and help identify the type of bacteria causing the abscess [4,29]. Furthermore, the earlier the causative agent is identified, the more effective the treatment will be in reducing mortality rates and improving the overall prognosis [30].…”