A brain abscess of probable odontogenic origin in a child with cyanotic heart disease

Pediatr Dent. 2012 Sep-Oct;34(5):403-6.

Abstract

The purpose of the present report was to present a rare case of a brain abscess in a child with heterotaxy syndrome, severe cardiac anomalies, and extensive dental caries. The pathogen was Streptococcus intermedius isolated from the cerebrospinal fluid. The source of the pathogen was probably an infection of a primary molar with a dentoalveolar abscess involving the bud of the permanent successor. After a long course of antibiotic regimens followed by a craniotomy with abscess drainage, a shunt, and comprehensive dental treatment, the patient was discharged from the hospital without any neurological sequel. At home, she completed an additional 3 months of oral antibiotics. This is the only known documented case of a toddler with a brain abscess of probable odontogenic origin without previous dental intervention. It emphasizes the importance of collaboration between cardiologists and pediatric dentists, especially in referring children with congenital heart defects for early dental checkups.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Brain Abscess / drug therapy
  • Brain Abscess / etiology*
  • Brain Abscess / microbiology*
  • Brain Abscess / surgery
  • Ceftriaxone / therapeutic use
  • Cerebrospinal Fluid Shunts
  • Child, Preschool
  • Craniotomy
  • Dental Caries / complications
  • Dextrocardia / complications
  • Female
  • Focal Infection, Dental / complications*
  • Focal Infection, Dental / drug therapy
  • Focal Infection, Dental / microbiology
  • Heart Defects, Congenital / complications*
  • Heterotaxy Syndrome / complications
  • Humans
  • Metronidazole / therapeutic use
  • Molar / pathology
  • Periapical Abscess / complications*
  • Streptococcal Infections / cerebrospinal fluid
  • Streptococcal Infections / complications*
  • Streptococcal Infections / drug therapy
  • Streptococcus intermedius / isolation & purification
  • Tooth Germ / pathology
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Metronidazole
  • Vancomycin
  • Ceftriaxone