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通过拔除患有慢性根尖病变的上颌磨牙以去除感染源来治疗多发性脑脓肿。

Multiple brain abscesses treated by extraction of the maxillary molars with chronic apical lesion to remove the source of infection.

作者信息

Jung Ki-Hyun, Ro Seong-Su, Lee Seong-Won, Jeon Jae-Yoon, Park Chang-Joo, Hwang Kyung-Gyun

机构信息

Department of Dentistry/Oral and Maxillofacial Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 South Korea.

出版信息

Maxillofac Plast Reconstr Surg. 2019 Jul 3;41(1):25. doi: 10.1186/s40902-019-0208-2. eCollection 2019 Dec.

Abstract

BACKGROUND

Brain abscess is a life-threatening condition that occurs due to complications during a neurosurgical procedure, direct cranial trauma, or the presence of local or distal infection. Infection in the oral cavity can also be considered a source of brain abscess.

CASE PRESENTATION

A 45-year-old male patient was transported with brain abscess in the subcortical white matter. Navigation-guided abscess aspiration and drainage was performed in the right mid-frontal lobe, but the symptoms continued to worsen after the procedure. A panoramic radiograph showed alveolar bone resorption around the maxillary molars. The compromised maxillary molars were extracted under local anesthesia, and antibiotics were applied based on findings from bacterial culture. A brain MRI confirmed that the three brain abscesses in the frontal lobe were reduced in size, and the patient's symptoms began to improve after the extractions.

CONCLUSION

This is a rare case report about multiple uncontrolled brain abscesses treated by removal of infection through the extraction of maxillary molars with odontogenic infection. Untreated odontogenic infection can also be considered a cause of brain abscess. Therefore, it is necessary to recognize the possibility that untreated odontogenic infection can lead to serious systemic inflammatory diseases such as brain abscess. Through a multidisciplinary approach to diagnosis and treatment, physicians should be encouraged to consider odontogenic infections as a potential cause of brain abscesses.

摘要

背景

脑脓肿是一种危及生命的疾病,可因神经外科手术并发症、直接颅脑外伤或局部或远处感染而发生。口腔感染也可被视为脑脓肿的一个来源。

病例介绍

一名45岁男性患者因皮质下白质脑脓肿入院。在右额中回行导航引导下脓肿穿刺引流术,但术后症状持续恶化。全景X线片显示上颌磨牙周围牙槽骨吸收。在局部麻醉下拔除受损的上颌磨牙,并根据细菌培养结果应用抗生素。脑部磁共振成像证实额叶的三个脑脓肿体积缩小,拔牙后患者症状开始改善。

结论

这是一篇关于通过拔除患有牙源性感染的上颌磨牙来消除感染从而治疗多个难治性脑脓肿的罕见病例报告。未经治疗的牙源性感染也可被视为脑脓肿的一个病因。因此,有必要认识到未经治疗的牙源性感染可能导致诸如脑脓肿等严重全身性炎症疾病的可能性。通过多学科的诊断和治疗方法,应鼓励医生将牙源性感染视为脑脓肿的潜在病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/6606678/cb2d784d0858/40902_2019_208_Fig1_HTML.jpg

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