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Case report
Medullary brain abscess secondary to dental procedure caused by Streptococcus intermedius
  1. Amit Verma1,
  2. Saad Qutab2 and
  3. Mahum Baig1
  1. 1Department of Medicine, East Sussex Healthcare NHS Trust, Eastbourne, East Sussex, UK
  2. 2Respiratory Medicine, Conquest Hospital, Hastings, East Sussex, UK
  1. Correspondence to Dr Amit Verma; a.verma1{at}nhs.net

Abstract

Brainstem abscess is an uncommon occurrence in itself and an abscess in the medulla oblongata is even rarer. Although these abscesses have established association with head and neck infections, we report the first known case of medullary abscess that was found to be strongly associated with dental procedure. Important point to note is that a simple procedure like tooth extraction can predispose spread of infective seeding to distant sites. High clinical index of suspicion and early diagnosis are essential, as if left untreated, the brainstem abscess is almost always fatal otherwise.

  • neurology (drugs and medicines)
  • brain stem / cerebellum
  • medical management
  • infection (neurology)
  • neurosurgery

https://doi.org/10.1136/bcr-2020-240769

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    Footnotes

    • Contributors AV was the main author involved with the patient’s case throughout the hospital admission and liaised with the neurosurgical team to arrange for the surgical intervention. AV collected all the data and images that we have included in this report. AV was also responsible for the initial raw draft of the case report. Along with the other authors, AV agreed to be accountable for all aspects of the report. SQ was a part of this project as a coauthor. SQ was involved in designing the report, analysis and literature review of similar cases and cross-referencing of the work. SQ also took part in the final review of the draft. SQ along with the other authors agreed to be accountable for all aspects of the report. MB was involved in the final stages of this Case report as coauthor. MB was responsible for reviewing the final draft and formatting of the work as per the journal’s requirement. MB along with the other authors agreed to be accountable for all aspects of the report.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

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