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BMJ Case Reports 2017; doi:10.1136/bcr-2016-218845
  • CASE REPORT

Case of a cerebral abscess caused by Porphyromonas gingivalis in a subject with periodontitis

Open AccessEditor's Choice
  1. Constantinus Politis
  1. OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium
  1. Correspondence to Dr Frederic Van der Cruyssen, frederic.vandercruyssen{at}uzleuven.be
  • Accepted 10 February 2017
  • Published 22 February 2017

Summary

We report the case of a 65-year-old man presenting with generalised seizures after developing a right frontal brain abscess. Stereotactic aspiration and subsequent matrix assisted laser desorption/ionisation time-of-flight analyzer (MALDI-TOF) spectrometry revealed Porphyromonas gingivalis as the only causative anaerobe microorganism. Secondary incision and drainage was required due to neurological deterioration with increased dimensions of the abscess, intracranial pressure and formation of a subdural occipitoparietal empyema. Oral imaging was positive for apical periodontitis of multiple elements; therefore, the remaining dentition was removed. Targeted antibiotic treatment included intravenous ceftriaxone and ornidazole. The patient was discharged to our revalidation unit 59 days after admission to make a full recovery. To the best of our knowledge, this is the sixth reported case of P. gingivalis causing an intracranial abscess and the third case of a true intracerebral parenchymal abscess caused by this bacterium.

Footnotes

  • Contributors FVdC was responsible for the study concept and design. FVdC carried out the literature search. KG and HM were responsible for initial proof reading. KG, HM and CP critically reviewed the manuscript for important intellectual content. CP was the study supervisor. All authors read and approved the final version of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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