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Case Reports
. 2025 Apr 14;17(1):2485197.
doi: 10.1080/20002297.2025.2485197. eCollection 2025.

Odontogenic brain abscess caused by Porphyromonas gingivalis and Streptococcus constellatus: a case report and review article

Siyu Sun  1 , Rui He  1 , Shan Chen  1 , Jing Ren  1 , Xinrong Ma  1 , Junying Yang  1
Affiliations
Case Reports

Odontogenic brain abscess caused by Porphyromonas gingivalis and Streptococcus constellatus: a case report and review article

Siyu Sun et al. J Oral Microbiol. .

Abstract

Background: Odontogenic brain abscess is a rare, but potentially fatal, central nervous system infection, with insidious onset and unclear etiology.

Methods: This case reports a 70-year-old male patient who developed an odontogenic brain abscess secondary to periodontal infection and underwent neurological surgery. Extract pus during surgery for the metagenomic next-generation sequencing (mNGS).

Results: The mNGS of pus samples obtained from brain abscess aspiration identified the periodontal pathogens Porphyromonas gingivalis and Streptococcus constellatus. Consequently, he was referred to the department of stomatology for further examination and treatment.

Conclusions: Our study found that major periodontal pathogens including P. gingivalis and S. constellatus were essential in the development of odontogenic brain abscesses; thus, timely intervention and preventive measures are important for treatment.

Keywords: Brain abscess; Porphyromonas gingivalis; Streptococcus constellatus; mNGS; periodontitis.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
MRI of the brain after admission showed a thin rim-enhancing lesion with perilesional edema in the right parietal lobe (A.B.E.F). The lesion had internal restricted diffusion on DWI and ADC (C.D).
Figure 2.
Figure 2.
MRI of the brain before discharge (A–D) Showed that the pus cavity in the right parietal lobe had notably narrowed, and peripheral cerebral edema had slightly reduced compared to previous imaging.
Figure 3.
Figure 3.
CBCT revealed that the full mouth alveolar bone was absorbed to varying degrees into the middle 1/3 of the root.
Figure 4.
Figure 4.
CBCT (A–C) Revealed that a high-density image of a suspected broken tooth in the left maxillary sinus.
See this image and copyright information in PMC

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