Do brain abscesses have a higher incidence of odontogenic origin than previously thought?

Hsu, Grace; Zhang, Jie; Selvi, Fırat; Shady, Neil; August, Meredith

doi:10.1016/j.oooo.2020.01.008

Cited by 21 publications

(24 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In these cases, inflammatory markers may be useful for early detection, although they are not diagnostic. Patients often have leukocytosis and elevated CRP [1]. Our patient presented with headache, vomiting, photophobia and left hemiparesthesia.…”

Section: Discussionmentioning

confidence: 72%

“…All of these organisms can be found in the oral cavity and can provide evidence of the etiology of BA. Oral pathogens from an odontogenic infection may enter the brain either by a hematological route (facial, angular, ophthalmic artery, spread through the cavernous sinus), by a lymphatic route or by direct extension through the fascial planes [1,4,7,10]. In both cases presented, the likely cause of brain abscess was hematogenous dissemination of odontogenic bacteremia.…”

Section: Discussionmentioning

confidence: 92%

“…The most common clinical signs suggestive of brain abscess are fever, headache and focal neurological deficits, early symptoms are often non-focal and include headache and nausea [1,5]. In these cases, inflammatory markers may be useful for early detection, although they are not diagnostic.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, modern sampling techniques should be used in order to positively confirm the role of an odontogenic infection in the pathogenesis of a brain abscess. BA of dental origin implies adequate treatment consisting of surgical drainage, antibiotic therapy for a long period of time and removal of the dental causative factor by extractions, endodontic treatment or periodontal therapy [1,5]. According to several authors [1,4,10,15] penicillin is still effective against most of the pathogens presented in these infections, and for this reason it is the first choice as an antibiotic, combined with ceftriaxone or cefotaxime and metronidazole these drugs have been shown to be effective against microorganisms involved in dental BA such as streptococci, gram-negative aerobes and strict anaerobes.…”

Section: Discussionmentioning

confidence: 99%

“…This condition occurs when oral bacteria from the primary dental infection reach the brain by direct contiguous invasion or by haematogenous route. The incidence of brain abscesses ranges from 0.4 to 0.9 per 100,000, with a high predisposition in immunocompromised patients [1,2]. with a foul odor was evacuated and was immediately sent for laboratory analysis, and the abscess drained, the wound was irrigated copiously with saline, and the craniotomy flap was reattached in its normal anatomical position before closing the wound with a 3/0 nylon suture.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Brain Abscess of Dental Origin: A Case Report and Literature Review

wissal¹

2021

J Med Healthcare

View full text Add to dashboard Cite

Introduction: Brain abscess (BA)of dental origin is a rare but potentially life-threatening complication of odontogenic infection that requires immediate neurosurgical attention. It is defined as an encapsulated collection of pus in various areas of the brain. The infectious process spreads from the dental site and occurs in 2 ways: haematogenous route or by contiguity. Treatment should ideally be based on the etiological factor excision, combined with drainage and adjuvant antibiotic therapy. The aim of this article was to report a case of frontal brain abscess of dental origin and to review the literature. Case report: We present the case of a 36-year-old man diagnosed with a brain abscess located in the frontal lobe and caused by a periodontal lesion of the right upper first molar. The final diagnosis was established due to the availability of computed tomography and magnetic resonance imaging. Drainage of the pus combined with extraction of the tooth and antibiotic therapy was followed by an excellent recovery. Clinical and radiological features, treatment and follow-up data were documented. A review of the literature using the PubMed database was performed Conclusion: Oral infections can lead to life-threatening infections, such as brain abscesses. Early detection of this condition through correct diagnosis is essential to give the patient the best treatment; in addition, improving of the oral environment and treating oral infections is highly recommended to limit this serious condition.

show abstract

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Brain Abscess of Dental Origin: A Case Report and Literature Review

wissal¹

2021

J Med Healthcare

View full text Add to dashboard Cite

show abstract

Undetected permanent dental inflammation as a possible trigger for brain abscesses? A retrospective analysis over the last 2 decades

Olivier,

Kraus,

Brandenburg

et al. 2024

Acta Neurochir

View full text Add to dashboard Cite

Background Recently, there is increasing evidence that the proportion of odontogenic brain abscesses is greater than previously known. In this study, we aim to differentiate the oral infections as triggers more precisely and to classify them in the clinical setting. Methods For analysis, we conducted a retrospective single center study. We reviewed patients with brain abscesses who have undergone treatment in the University Hospital of Freiburg, Germany in the period between 2000–2021. Inclusion required two main criteria: 1. The brain abscess must not have an other focus than odontogenic. 2. The microbial spectrum identified in the brain abscess must be consistent with an odontogenic origin. Results Of 217 brain abscess patients, 26 met the inclusion criteria. 42% (11 patients) suffered from immunosuppressive conditions. Odontogenic foci were diagnosed in 18 cases (69%). Neurologic deficits included vigilance reduction and hemiparesis. Pathogens of the Streptococcus anginosus group were the most frequent causative agent (21 cases, 81%). Metronidazole (54%) and ceftriaxone (42%) were part of the targeted antibiotic therapy. All brain abscesses were surgically treated. Teeth were extracted in 14 of 17 cases for focus control. 18 cases (72%) showed complete or partial resolution of neurologic symptoms and 3 cases were fatal. Conclusion Apparently silent or chronic oral infections are sufficient to cause bacterial colonization of the brain, especially in immunocompromised patients. Therefore, special care should be taken to maintain good oral health. An interdisciplinary management should become a standard to prevent and treat the occurrence of brain abscesses.

show abstract

Cerebral abscesses with odontogenic origin: a population-based cohort study

et al. 2023

View full text Add to dashboard Cite

Objectives Recent studies have indicated that cerebral abscess (CA) patients with odontogenic origin are on the rise. However, CA patients are often poorly characterized and with an unknown etiologic background. The purpose of this study is to identify and characterize CA patients that may have an odontogenic origin based on microbiologic, radiographic, and/or clinical findings. Materials and methods This is a population-based cohort study analyzing retrospective and prospective data from CA patients. Radiographic examinations of panoramic radiographs (PRs) or computed tomography (CT) scans were conducted. CA patients characterized with odontogenic origin required the fulfilment of the following criteria on admission: (1) Oral pathologic conditions were the only bacterial infections present, (2) oral microorganisms were isolated in the purulent exudate from the brain, and (3) radiographically and/or clinical recordings of oral pathologic conditions. Results A total of 44 patients could be included in this study of which 25 (57%) were characterized as having CA with a likely odontogenic origin. Type two diabetes (T2D) (p = 0.014) and microorganisms of the Streptococcus anginosus group (SAG) (p < 0.01) were overrepresented in patients with CAs of odontogenic origin. Conclusions Odontogenic infections may cause CAs to a greater extent than previously assumed. T2D was overrepresented among patients with odontogenic CA. When microorganisms of the SAG were isolated from the brain pus, CA patients had a predisposing odontogenic or sinus infection. Clinical relevance The identification of patients with a likely odontogenic CA will contribute to understanding the etiology of the infectious disease and highlighting the importance of preserving oral health.

show abstract

Do brain abscesses have a higher incidence of odontogenic origin than previously thought?

Cited by 21 publications

References 19 publications

Brain Abscess of Dental Origin: A Case Report and Literature Review

Brain Abscess of Dental Origin: A Case Report and Literature Review

Undetected permanent dental inflammation as a possible trigger for brain abscesses? A retrospective analysis over the last 2 decades

Cerebral abscesses with odontogenic origin: a population-based cohort study

Contact Info

Product

Resources

About