Cerebral abscess of odontogenic origin

Abstract

Introduction: Cerebral abscess is a rare but serious and life-threatening infection. Dental infections have occasionally been reported as the source of bacteria for such an abcess.

Patient and methods: A 54-year-old man was admitted with a right hemiparesis and epileptic fits. After clinical, laboratory and imaging examination, the diagnosis of a cerebral abscess of the left parietal lobe was made. The intraoral clinical examination as well as a panoramic radiograph confirmed the presence of generalized periodontal disease, multiple dental caries, and periapical pathology. The treatment included: (i) Immediate administration of high-dose intravenous antibiotics and (ii) surgical procedures consisting of craniotomy and resection of the abscess cavity first, and secondly removal of the periodontal, decayed and periapically involved teeth of the patient, in an effort to eradicate all the possible septic foci, presuming the cerebral abscess to be of odontogenic infection.

Results: The patient made an uneventful recovery, and 29 months postoperatively he had completely recovered from the hemiparesis.