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

Abstract 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.
PMID
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Authors

Mayor MeshTerms

Porphyromonas gingivalis

Keywords
Journal Title bmj case reports
Publication Year Start




PMID- 28228396
OWN - NLM
STAT- MEDLINE
DA  - 20170223
DCOM- 20170310
LR  - 20170310
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2017
DP  - 2017 Feb 22
TI  - Case of a cerebral abscess caused by Porphyromonas gingivalis in a subject with
      periodontitis.
LID - bcr2016218845 [pii]
LID - 10.1136/bcr-2016-218845 [doi]
AB  - 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.
CI  - 2017 BMJ Publishing Group Ltd.
FAU - Van der Cruyssen, Frederic
AU  - Van der Cruyssen F
AUID- ORCID: http://orcid.org/0000-0002-6888-9219
AD  - OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of
      Medicine, Catholic University Leuven, Leuven, Belgium.
FAU - Grisar, Koenraad
AU  - Grisar K
AD  - OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of
      Medicine, Catholic University Leuven, Leuven, Belgium.
FAU - Maes, Honorine
AU  - Maes H
AD  - OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of
      Medicine, Catholic University Leuven, Leuven, Belgium.
FAU - Politis, Constantinus
AU  - Politis C
AD  - OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of
      Medicine, Catholic University Leuven, Leuven, Belgium.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20170222
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
SB  - IM
MH  - Aged
MH  - Bacteroidaceae Infections/*complications
MH  - Brain Abscess/diagnostic imaging/*microbiology/therapy
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Periodontitis/*complications/therapy
MH  - *Porphyromonas gingivalis
EDAT- 2017/02/24 06:00
MHDA- 2017/03/11 06:00
CRDT- 2017/02/24 06:00
AID - bcr-2016-218845 [pii]
AID - 10.1136/bcr-2016-218845 [doi]
PST - epublish
SO  - BMJ Case Rep. 2017 Feb 22;2017. pii: bcr2016218845. doi: 10.1136/bcr-2016-218845.

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