title: Brain abscess associated with Aggregatibacter actinomycetemcomitans: case report and review of literature.
abstract: BACKGROUND
  Aggregatibacter actinomycetemcomitans is considered a major pathogen in localized and generalized aggressive periodontitis. A. actinomycetemcomitans has been found in various extra oral infections and most frequently in endocarditis. We report a patient with multiple brain abscesses due to infection with A. actinomycetemcomitans and review the English language literature related to this subject.
  
  
  METHODS
  A 42-year-old patient with no underlying medical conditions presented with multiple brain lesions initially thought to be metastatic lesions of a tumour of unknown origin. Findings during drainage and subsequent histopathological conclusions made infection more likely. Culture of drained material remained negative; however, 16S rDNA polymerase chain reaction and sequence analysis on direct material revealed A. actinomycetemcomitans as the causative agent of the infection. The most likely source of infection was the poor dentition of the patient. After repeated drainage of the lesions and antibiotic treatment the patient gradually improved, although cognitive impairment remained.
  
  
  CONCLUSIONS
  Our report illustrates that a poor dental condition, notably destructive periodontal disease, can be a risk for life-threatening extra oral disease, and thus contributes to the total inflammatory burden of the body.
authors.affiliation: Department of Microbiology, Izore Centre for Infectious Diseases Friesland, Leeuwarden, The Netherlands. j.c.rahamat@mmb.umcg.nl
authors.forename: Janette C
authors.initials: JC
authors.lastname: Rahamat-Langendoen
authors.forename: Marit G A
authors.initials: MG
authors.lastname: van Vonderen
authors.forename: Lex J
authors.initials: LJ
authors.lastname: Engström
authors.forename: Willem L
authors.initials: WL
authors.lastname: Manson
authors.forename: Arie Jan
authors.initials: AJ
authors.lastname: van Winkelhoff
authors.forename: Esther A N M
authors.initials: EA
authors.lastname: Mooi-Kokenberg
mesh_terms: D000189:Actinobacillus Infections / Q000175:diagnosis*; D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000502:physiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001706:Biopsy; D001922:Brain Abscess / Q000382:microbiology*; D002443:Ceftriaxone / Q000627:therapeutic use; D003731:Dental Caries / Q000175:diagnosis; D004322:Drainage; D005491:Focal Infection, Dental / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D010510:Periodontal Diseases / Q000175:diagnosis
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D002443:Ceftriaxone