Intracranial abscess as a complication of acute bacterial sinusitis of odontogenic origin – a case report

Abstract

<b><br>Introduction:</b> Odontogenic sinusitis (ODS) is an inflammatory process of bacterial etiology (most commonly associated with anaerobes), which may lead to life threatening complications such as intracranial abscess.</br> <b><br>Aim:</b> The aim was to discuss the stages of abscess formation as a rhinosinusitis complication, their pathology, as well as corresponding computed tomography (CT) and magnetic resonance imaging (MRI) images are presented, based on presented case report.</br> <b><br>Case report:</b> We described a case of a 26-year-old man who developed intracranial complications – a frontal lobe abscess – in the course of ODS. Intravenous, empiric antibiotic therapy was implemented, and then the frontal sinus, anterior and posterior ethmoid cells, frontal sinus and sphenoid sinus were opened. Due to the lack of significant improvement in the patient’s condition and the increase in size of purulent collections, a decision to perform reoperation was made: the access to the frontal sinus was widened and the empyema localized behind posterior wall of the frontal sinus was drained.</br> <b><br>Conclusions:</b> Intracranial abscess as a consequence of untreated ODS and acute bacterial rhinosinusitis (ABRS) is difficult to identify at the early stages. Treatment of complicated ODS requires long-term antibiotic therapy and, in some cases, surgical intervention.</br>