Case ReportMultiple brain abscesses in an immunocompetent patient after undergoing professional tooth cleaning
Section snippets
CASE REPORT
The patient, a 55-year-old man, sought care at a medical center because he had experienced an acute onset of weakness in his left leg. Until then, he had been in good health and had no known pre-existing conditions. The patient reported that he had received a professional tooth cleaning from his dentist 10 days before he was transferred from the medical center to our hospital (University Hospital of Dresden, Germany). He also reported that he began shivering later on the day he had his teeth
DISCUSSION
A brain abscess is rare but life threatening. It consists of a focal cerebral infection surrounded by a well-vascularized capsule. Its clinical presentation is highly variable and depends on the size and location of the abscess, the virulence of the infectious organism and the presence of pre-existing conditions.4 Typical symptoms are headache, nausea, vomiting and an impaired level of consciousness.5, 6 In addition to either a direct infection occurring after experiencing a penetrating head
CONCLUSION
This case we present suggests that, in individual cases, prophylactic professional tooth cleaning may cause transient bacteremia that may lead to brain abscesses even in patients who are immunocompetent. Specific precautions are not known. Treatment of these patients should be interdisciplinary and involve neurologists, neurosurgeons, dentists and oral and maxillofacial surgeons.
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Cited by (0)
Disclosure. Dr. Reichmann has sat on advisory boards for, given lectures on behalf of and received research grants from Abbott, Bayer Health Care, Boehringer/Ingelheim, Brittania, Cephalon, Desitin, GSK, Lundbeck, Merck-Serono, Novartis, Orion, Pfizer, TEVA, UCB Pharma and Valeant. None of the other authors reported any disclosures.
- 1
Dr. Pallesen is a resident and a neurologist, Department of Neurology, Technical University Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- 2
Dr. Schaefer is a senior physician and a neurologist, Department of Neurology, Technical University Dresden, Germany.
- 3
Dr. Reuner is a senior physician and a neurologist, Department of Neurology, Technical University Dresden, Germany.
- 4
Dr. Leonhardt is a resident, Department of Oral and Maxillofacial Surgery, Technical University Dresden, Germany.
- 5
Dr. Engellandt is a senior physician, Department of Neuroradiology, Technical University Dresden, Germany.
- 6
Dr. Schneider is a senior physician and a neurologist, Department of Neurology, Technical University Dresden, Germany.
- 7
Dr. Reichmann is a professor and the chair, Department of Neurology, and the dean of the medical faculty, Technical University Dresden, Germany.
- 8
Dr. Puetz is a senior physician and a neurologist, Department of Neurology, Technical University Dresden, Germany.