Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul;27(7):3639-3648.
doi: 10.1007/s00784-023-04976-6. Epub 2023 Mar 31.

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

Frederik V B Jespersen  1   2 , Signe U-B Hansen  1 , Simon S Jensen  1   2 , Lars H Omland  3 , Jannik Helweg-Larsen  3 , Thomas Bjarnsholt  4   5 , Claus H Nielsen  1   6 , Morten Ziebell  7 , Jacob Bodilsen  8 , Merete Markvart  9
Affiliations

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

Frederik V B Jespersen et al. Clin Oral Investig. 2023 Jul.

Abstract

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.

Keywords: Brain abscess; Dental infection control; Microbiology; Oral health; Oral pathology; Panoramic radiography.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow of patients. Patients with CA included in the DASGIB cohort were all screened for eligibility. Patients were excluded if they did not meet the inclusion criteria. In total, 44 patients were included
Fig. 2
Fig. 2
Flowchart showing the characterization of CA patients with odontogenic origin
Fig. 3
Fig. 3
Bacterial spectrum and correlation of pathogens with presumed cause of CA formation
See this image and copyright information in PMC

References

    1. Helweg-Larsen J, Astradsson A, Richhall H, Erdal J, Laursen A, Brennum J. Pyogenic brain abscess, a 15 year survey. BMC Infect Dis. 2012;12:332. doi: 10.1186/1471-2334-12-332. - DOI - PMC - PubMed
    1. Brouwer MC, Tunkel AR, McKhann GM, Van De BD. Brain abscess. N Engl J Med. 2014;371:447–456. doi: 10.1056/NEJMra1301635. - DOI - PubMed
    1. Brouwer MC, Coutinho JM, Van De BD. Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology. 2014;82(Suppl):806–813. doi: 10.1212/WNL.0000000000000172. - DOI - PubMed
    1. Brouwer MC, Van De BD. Epidemiology, diagnosis, and treatment of brain abscesses. Curr Opin Infect Dis. 2017;30:129–134. doi: 10.1097/QCO.0000000000000334. - DOI - PubMed
    1. Bodilsen J, Dalager-Pedersen M, van de Beek D, Brouwer MC, Nielsen H. Incidence and mortality of brain abscess in Denmark: a nationwide population-based study. Clin Microbiol Infect. 2020;26(Suppl):95–100. doi: 10.1016/j.cmi.2019.05.016. - DOI - PubMed