Odontogenic Cellulitis Complicating Multifocal Brain Abscess and Bacterial Meningitis in a Pregnant Woman: about a Case

Luny Anjaratiana Rakotonoely*
CHU-JR Befelatanana Hospital, Antananarivo Madagascar
*Corresponding Author: Luny Anjaratiana Rakotonoely, CHU-JR Befelatanana Hospital, Antananarivo Madagascar.

Published: November 05, 2024

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Abstract  

A brain abscess, an intracerebral purulent collection caused by bacterial, fungal, or parasitic infections, often arises from primary infectious foci in the ENT sphere or by contiguity. Although rare, it poses significant risks, especially in vulnerable populations such as pregnant women. This report presents the case of a 24-year-old woman at 29 weeks of amenorrhea, admitted for progressive worsening headaches. Initial symptoms included nocturnal paroxysms with bilateral frontal location radiating to the neck, evolving into language disorders and right hemibody functional impairment without convulsive seizures, all in a febrile context suggesting an infection. Notably, the patient had undergone a pus drainage procedure for odontogenic cellulitis one week prior. Clinical examination revealed febrile status, meningeal syndrome, and neurological deficits including dysarthria and right hemiparesis. MRI results showed multiple brain abscesses with peri-lesional cerebral edema. Antibiotic and corticosteroid therapy yielded significant clinical improvement. However, post-treatment imaging revealed hydrocephalus, necessitating extended antibiotic therapy. This case underscores the importance of timely diagnosis and treatment of ENT infections to prevent severe intracerebral complications, particularly in immunocompromised patients.

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