Oral bacteria may be an under-recognised cause of brain abscesses

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-11-24T20:00:30+05:30 | Updated On 25 Nov 2022 11:35 AM IST

The oral cavity could be considered a source of occult infection in cases of brain abscess where no clear cause has been identified suggests a recent study published in the Journal of Dentistry.

Intracranial abscesses are relatively uncommon but can result in significant mortality and morbidity. Whilst many potential causes of brain abscesses are recognised, in many cases, the origin of infection remains clinically unidentified. Our objective was to investigate the role of bacteria found in the oral cavity in the development of brain abscesses.

A retrospective analysis was performed using data from 87 patients admitted to a single UK neurosurgical unit with brain abscesses over a 16-year period. Using microbiological data obtained from abscess sampling and peripheral cultures, species of bacteria were categorised in patients where no primary source of infection was identified (NSI) for their brain abscess (n=52), or where an infective source (ISI) was identified. The microbiological data was then screened to identify common oral bacteria in each group.

Results

Brain abscesses from the ISI group (n=35) demonstrated a significantly lower preponderance of oral bacteria (n=8), than the NSI group (n=29) (p<0.05).
Brain abscesses from the NSI group also had significantly higher counts of Streptococcus Anginosus compared to ISI (p<0.05), with brain abscesses being most common in the frontal and parietal lobes for both ISI and NSI.

These findings suggest that the oral cavity could be considered as a source of occult infection in cases of brain abscess where no clear cause has been identified. Future studies should include oral screening and microbiome analysis to better understand the mechanisms involved and develop approaches for prevention. Oral bacteria may be an under-recognised cause of brain abscesses. Careful review of oral health in brain abscess patients may help establish causation, particularly in patients with no cause for their abscess identified. Good levels of oral health may help prevent the development of brain abscesses in some individuals.

Reference:

Holly Roy, Raul Bescos, Ewen McColl, Umar Rehman, Elizabeth Cray, Louise A. Belfield, King-David Nweze, Kevin Tsang, William Singleton, Peter Whitfield, Zoe Brookes. Oral microbes and the formation of cerebral abscesses: a single-centre retrospective study, Journal of Dentistry, 2022, 104366, ISSN 0300-5712, https://doi.org/10.1016/j.jdent.2022.104366.

(https://www.sciencedirect.com/science/article/pii/S0300571222004183)

Brain abscessintracranial abscessOral microbiomeStreptococcusAnginosusJournal of Dentistry

Source : Journal of Dentistry

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751