Porphyromonas gingivalis as an uncommon cause of intracranial abscesses

摘要

A 66-year-old woman presented with an approximately 15-day history of headache and no associated symptoms. Her complete blood counts were normal, and blood and urine cultures were negative. Brain magnetic resonance imaging showed multiple lesions in the bilateral temporal and right frontal lobes with T2 hyperintensity, restricted diffusibility, and peripheral enhancement, suggesting abscesses (Figure 1A–C). Porphyromonas gingivalis was confirmed as the etiological agent via biopsy. Subsequently, the family members reported that the patient had undergone a dental procedure 1 month before symptom onset. Because of a delayed surgical approach, the lesions progressed and the patient developed an ischemic vascular insult in the territory of the middle cerebral arteries (Figure 1D), probably related to vasculitis secondary to the adjacent inflammatory/infectious process.