Streptococcus constellatus and sinusitis: A brain abscess case series

Abstract

Background: Brain abscess is an infectious process affecting the central nervous system and related structures and is many times the result of bacterial translocation from other areas of the body. Patients can present in a multitude of ways, ranging from sepsis to stroke, creating an ambiguous initial disease presentation. Through imaging, lab work, and surgical intervention and biopsy, an official diagnosis of brain abscess can be made; moreover, timely recognition and antibiotic treatment are paramount to creating positive patient outcomes. Case Description: We present a rare case of brain abscess caused by Streptococcus constellatus and Parvimonas micra from likely sinusitis, with appropriate biopsy and treatment. We aim to explore the underlying pathophysiology of brain abscesses, the different bacteria which may cause this disease process, differentials, and treatment. We also conducted a literature review for similar cases caused by Streptococcus constellatus and Parvimonas micra to highlight the rare yet dangerous nature of this infectious disease. Through our case report and series of similar cases, we presented the unusual development of brain abscess after a sinus infection and contiguous spread. Streptococcus constellatus and Parvimonas micra is an organism that can cause brain abscess but is rare to be seen in individuals without sinus or odontogenic disease. Prompt identification through clinical signs, labs, imaging, cultures and biopsy can help aid in creating better patient outcomes. Conclusion: This case series delineated the pathophysiology, diagnosis, and management of brain abscess that resulted from contiguous bacterial spread. Timely diagnosis and treatment initiation are paramount to reducing mortality associated with brain abscess.