2026 Volume 75 Issue 2 Pages 458-464
An 80-year-old man presented to the emergency department with generalized fatigue and loss of appetite. Although no focal neurological deficits were initially observed, contrast-enhanced computed tomography (CT) revealed a mass in the right frontal lobe, raising concern for a metastatic brain tumor. He was referred to the neurosurgery department, where one week later he developed left-sided hemiparesis. Repeat imaging with contrast-enhanced CT and magnetic resonance imaging (MRI) confirmed the diagnosis of a brain abscess. The patient underwent right craniotomy and abscess drainage. Cultures of the purulent material grew Streptococcus intermedius and Haemophilus parainfluenzae. Targeted antimicrobial therapy in combination with surgical drainage resulted in temporary improvement. However, his clinical course was complicated by progressive aspiration pneumonia, and he died on hospital day 61. Marked oral contamination and severe periodontitis suggested an odontogenic source of the abscess. This case underscores the importance of early oral hygiene management and close monitoring for infectious complications.
