Multiple brain abscesses in an immunocompetent patient after undergoing professional tooth cleaning

Lars-Peder Pallesen; Jochen Schaefer; Ulrike Reuner; Henry Leonhardt; Kay Engellandt; Hauke Schneider; Heinz Reichmann; Volker Puetz

doi:10.14219/jada.2014.20

Multiple brain abscesses in an immunocompetent patient after undergoing professional tooth cleaning

J Am Dent Assoc. 2014 Jun;145(6):564-8. doi: 10.14219/jada.2014.20.

Authors

Lars-Peder Pallesen¹, Jochen Schaefer², Ulrike Reuner³, Henry Leonhardt⁴, Kay Engellandt⁵, Hauke Schneider⁶, Heinz Reichmann⁷, Volker Puetz⁸

Affiliations

¹ Dr. Pallesen is a resident and a neurologist, Department of Neurology, Technical University Dresden, Fetscherstraße 74, 01307 Dresden, Germany, e-mail [email protected]. Address correspondence to Dr. Pallesen.
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.

PMID: 24878711
DOI: 10.14219/jada.2014.20

Abstract

Background: Dental disorders and dental treatment are among the variety of causes of brain abscess.

Case description: The authors present the case of a patient who developed multiple brain abscesses after undergoing professional tooth cleaning. The results of a diagnostic work-up ruled out an underlying immunodeficiency. After receiving neurosurgical intervention and intensive care treatment by means of local and intravenous antibiotics for 24 days, the patient was transferred to another hospital for rehabilitation. Six months after the treatment, the patient still had moderate residual paresis of the left leg.

Practical implications: Although it happens rarely, professional tooth cleaning may be considered a cause of brain abscesses even in otherwise healthy patients.

Keywords: Abscess; dental care; immunology; microbiology; prophylaxis.

Publication types

Case Reports

MeSH terms

Brain Abscess / diagnostic imaging*
Brain Abscess / etiology
Humans
Immunocompetence*
Male
Middle Aged
Oral Hygiene*
Radiography