Background:

Brain abscesses are a serious neurological emergency with a high risk of permanent neurological deficit. The pathology is a rare in the pediatric age: the annual incidence is 0.5 per 100,000 children. There are a few studies of brain abscesses of oral origin mostly in adult patients with an underlying dental pathology. Eikenella corrodens, a slow-growing, Gram negative, facultatively anaerobic rod-bacillus, is part of the oral cavity biota, and common as a pathogen in head, neck, and dental infections.

Case report:

A previously healthy 16-year-old male presented a headache of 2 months of evolution accompanied by nausea and vomiting. Four months earlier, the fourth upper right molar was extracted, with no antibiotic prophylactic treatment. Magnetic resonance imaging of the skull showed a lesion compatible with brain abscess. Stereotaxy-guided puncture drainage was performed, isolating E. corrodens. The treatment was with ceftriaxone and metronidazole intravenously for four weeks and ampicillin sulbactam orally for two more weeks.

Conclusions:

Brain abscesses of odontogenic origin by E. corrodens in the pediatric age are very rare. Currently, the use of prophylactic antibiotics in dental procedures is controversial because the indiscriminate use increases antimicrobial resistance. The optimization of diagnostic studies and multidisciplinary treatment has improved the prognosis of patients with brain abscesses.