Ann Infect Dis Epidemiol | Volume 4, Issue 1 | Case Report | Open Access
Mary M McKenna*, Recia L Frenn and Jean R Goodman
Department of Obstetrics and Gynecology, Loyola University Medical Center, USA
*Correspondance to: Mary M McKenna
Fulltext PDFIntroduction: Brain abscesses are extremely rare, potentially life-threatening events that require immediate neurosurgical evaluation. Less than 10% of brain abscesses have been attributed to be from dental infection. We describe a case of a pregnant women with twins who developed a brain abscess as a result of sinusitis due to dental caries, masked by a diagnosis of preeclampsia. Case: 21-year-old gravida 2 para 1 at 36 weeks and 3 days with dichorionic diamniotic twins presented to labor and delivery triage with a severe headache, nausea and vomiting, diagnosed with preeclampsia with severe features and recommended to undergo delivery. Prior to delivery the patient developed altered mental status with expressive aphasia, as well as a fixed and dilated left pupil. Computed tomography revealed 6 mm left-sided holo-hemispheric subdural fluid collection with mass effect, brain edema, and midline shift. She underwent emergent craniotomy with neurosurgery with intraoperative findings consistent with subdural empyema. After further workup, the intracranial empyema was thought secondary to bacterial sinusitis, originating from persistent dental caries. Conclusion: Dental care in pregnancy is an important, yet commonly unaddressed topic at prenatal care visits. While there are many complications that can result from poor dental hygiene, including dental caries, gingivitis and preterm delivery, brain abscess is among the most severe. This case illustrates the importance of addressing good nutrition as well as oral hygiene habits at prenatal visits and throughout pregnancy.
McKenna MM, Frenn RL, Goodman JR. Brain Abscess in Pregnancy as a Result of Dental Caries with Sinusitis. Ann Infect Dis Epidemiol. 2019; 4(1): 1040.