Schuman N J, Turner J E
Department of Biologic and Diagnostic Sciences, University of Tennessee, College of Dentistry, Memphis 38163.
Quintessence Int. 1994 Jun;25(6):411-3.
Brain abscess is a rare, extremely aggressive, life-threatening infection. A mortality rate of between 36% and 90% has been reported as recently as 1990. It is resistant to antibiotics and is one of the few bacterial infections whose morbidity and mortality statistics remain unaffected by the development of antimicrobial medications. Successful treatment appears to be dependent on early diagnosis, surgical intervention, and direct antibiotic irrigation of the surgical wound site, as well as intravenous administration of high doses of antibiotics throughout the crisis. It has been suggested that there is a relationship between dental infection or treatment and brain abscess. Dental infection and treatment have been found culpable in numerous cases reported in the literature. However, careful review of the articles reveals that dental infection or treatment has often been named as a causative factor (1) solely because an infection or treatment occurred within several months of brain abscess; (2) when nondental bacteria were cultured from the brain abscess; and (3) without culturing both the dental infection and the brain abscess to ascertain flora match.
脑脓肿是一种罕见的、极具侵袭性且危及生命的感染。就在1990年，据报道其死亡率在36%至90%之间。它对抗生素具有耐药性，是少数几种发病率和死亡率统计数据不受抗菌药物发展影响的细菌感染之一。成功的治疗似乎依赖于早期诊断、手术干预、对手术伤口部位进行直接抗生素冲洗，以及在整个病程中静脉注射高剂量抗生素。有人提出牙齿感染或治疗与脑脓肿之间存在关联。在文献报道的众多病例中，牙齿感染和治疗被认定有过错。然而，仔细研读这些文章会发现，牙齿感染或治疗常被列为致病因素的情况有：(1) 仅仅因为在脑脓肿发生的几个月内出现了感染或治疗；(2) 当从脑脓肿中培养出非牙齿细菌时；(3) 没有对牙齿感染和脑脓肿都进行培养以确定菌群匹配情况。
