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牙源性感染引起的脑部并发症:系统评价。

Brain complications from odontogenic infections: A systematic review.

机构信息

Department of Clinical Specialities, Faculty of Dentistry, Complutense University of Madrid, Spain; Concepción University, Chil.

Department of Clinical Specialities, Faculty of Dentistry, Complutense University of Madrid, Spain; San Pablo-CEU University, Madrid, Spain.

出版信息

J Stomatol Oral Maxillofac Surg. 2022 Nov;123(6):e794-e800. doi: 10.1016/j.jormas.2022.07.018. Epub 2022 Jul 29.

Abstract

PURPOSE

Odontogenic infections can spread through different routes to more remote anatomical areas, such as the brain. Brain abscesses have an incidence of 0.3-1.3 / 100,000 population and only 2-5% are of dental origin. The main objective is to research brain complications derived from odontogenic infections. Secondary objectives were to identify the most common symptoms in brain abscess, to describe the microbiology involved in these infectious processes, report which parts of the brain complex are most commonly affected and report the sequelae of this patients.

METHODS

A systematic review following the PRISMA Guide and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports was carried out in PubMed, Scopus and Web of Science. The search terms were: Brain infection, brain abscess, oral health oral origin, odont* infect*.

RESULTS

The database search identified a total of 1000 articles. A total of 18 publications were identified after applying inclusion and exclusion criteria. A total of 38 patients were analyzed. Mean age was 49.64±18.80 years.

CONCLUSION

The most common symptoms of patients with brain abscess are neurological affectations first and then fever and headache second, without necessarily presenting as a symptomatological triad. Microbiological diagnosis is key to determining the origin of the infection. Anaerobic pathogens such as Streptococcus (F. Milleri), Fusobacterium Nucleatum and Porfiromonas Gingivalis families are common bacterial agents. The frontal lobe is the most frequently affected, followed by the parietal and temporal lobe. The most frequent brain complications are neurological disorders. However, most patients with brain abscesses recover without sequelae.

摘要

目的

牙源性感染可通过不同途径扩散至更远处的解剖区域,如大脑。脑脓肿的发病率为 0.3-1.3/10 万,其中只有 2-5% 是牙源性的。主要目的是研究牙源性感染引起的脑并发症。次要目标是确定脑脓肿最常见的症状,描述这些感染过程中涉及的微生物学,报告大脑复杂部位最常受影响的部位,并报告这些患者的后遗症。

方法

在 PubMed、Scopus 和 Web of Science 中按照 PRISMA 指南和 Joanna Briggs 研究所(JBI)病例报告批判性评估清单进行了系统评价。检索词为:脑感染、脑脓肿、口腔健康、口腔起源、odont* infect*。

结果

数据库搜索共确定了 1000 篇文章。经过纳入和排除标准的应用,共确定了 18 篇出版物。共分析了 38 名患者。平均年龄为 49.64±18.80 岁。

结论

脑脓肿患者最常见的症状首先是神经功能障碍,其次是发热和头痛,不一定表现为三联征。微生物学诊断是确定感染来源的关键。厌氧病原体如链球菌(F. Milleri)、核梭杆菌和卟啉单胞菌属是常见的细菌病原体。额叶是最常受影响的部位,其次是顶叶和颞叶。最常见的脑并发症是神经功能障碍。然而,大多数脑脓肿患者无后遗症恢复。

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