[Multiple brain abscesses of odontogenic origin caused by Fusobacterium nucleatum]

Abstract

Infection caused by the anaerobic gram-negative rod Fusobacterium nucleatum belongs to endogenous infections. A 41-year-old man developed multiple brain abscesses of odontogenic origin. The main causes were poor oral hygiene and no dental check-ups. Pus aspired from a site in the brain contained DNA of the bacterium Fusobacterium nucleatum. Several teeth with periapical abscesses were extracted. Initially, the patient was treated empirically with a combination of cefotaxime and metronidazole (18 days). Subsequently, co-trimoxazole and rifampicin were administered (8 months). Four and eight months after the onset of the disease, MRI scans revealed only persistent residual changes in the brain parenchyma; the patient was asymptomatic, with no neurological signs and back at work.