Use of FDG-PET to detect a chronic odontogenic infection as a possible source of the brain abscess.
This study describes the use of (18)F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) to detect a chronic odontogenic infection as the possible origin of a brain abscess (BA). A 74-year-old man with esophageal carcinoma was referred to our department to determine the origin of a BA in his oral cavity. He had no acute odontogenic infections. The BA was drained, and bacteria of the Staphylococcus milleri group were detected. Whole body FDG-PET revealed that the only sites of definite uptake of FDG were the esophageal carcinoma and the left upper maxillary region (SUVmax: 4.5). These findings suggested that the BA may have originated from a chronic periodontal infection. Six teeth with progressive chronic periodontal disease were extracted to remove the possible source of BA. These findings excluded the possibility of direct spread of bacteria from the odontogenic infectious lesion to the intracranial cavity. After extraction, there was no relapse of BA.
Division of Oral Pathobiological Science, Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, North 13, West 7, Kita-ku, Sapporo, 060-8586, Japan. jun-s@den.hokudai.ac.jp.
Jun
J
Sato
Division of Oral Pathobiological Science, Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, North 13, West 7, Kita-ku, Sapporo, 060-8586, Japan.
Takeshi
T
Kuroshima
Division of Oral Pathobiological Science, Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, North 13, West 7, Kita-ku, Sapporo, 060-8586, Japan.
Mayumi
M
Wada
Division of Oral Pathobiological Science, Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, North 13, West 7, Kita-ku, Sapporo, 060-8586, Japan.
Akira
A
Satoh
Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
Shiro
S
Watanabe
Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
Shozo
S
Okamoto
Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
Tohru
T
Shiga
Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
Nagara
N
Tamaki
Division of Oral Pathobiological Science, Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, North 13, West 7, Kita-ku, Sapporo, 060-8586, Japan.
Yoshimasa
Y
Kitagawa
D000368:Aged; D001922:Brain Abscess / Q000209:etiology*; D004938:Esophageal Neoplasms / Q000150:complications; D005459:Fluorides; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D010510:Periodontal Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology; D049268:Positron-Emission Tomography; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging*; D013210:Staphylococcus / Q000302:isolation & purification
D019788:Fluorodeoxyglucose F18; D005459:Fluorides
Brain abscess; Chronic infection; FDG-PET; Odontogenic infection