# Brain Abscess Caused by Streptococcus intermedius and Aggregatibacter aphrophilus Secondary to Exfoliation of a Deciduous Tooth in a Previously Healthy Child: A Case Report

## TL;DR

A healthy child developed a brain abscess after a tooth fell out, showing how even minor oral events can lead to serious infections.

## Contribution

Highlights the rare but serious risk of brain abscess from deciduous tooth exfoliation in healthy children.

## Key findings

- A brain abscess occurred after a tooth exfoliated in a previously healthy child.
- Infection was caused by oral bacteria Streptococcus intermedius and Aggregatibacter aphrophilus.
- The child fully recovered after surgical drainage and antibiotics.

## Abstract

This report describes the case of a previously healthy nine-year-old girl who developed a left temporal lobe brain abscess following spontaneous exfoliation of a healthy deciduous tooth. She presented in convulsive status epilepticus without fever or focal neurological symptoms, and the initial MRI revealed a ring-enhancing lesion with adjacent dural inflammation. Surgical drainage and intravenous antibiotic therapy led to a full recovery with no neurological sequelae after six weeks of treatment. Pus culture revealed Streptococcus intermedius and Aggregatibacter aphrophilus, both of which are part of the normal oral flora. The route of infection in this case is suggested to be hematogenous spread from the site of tooth exfoliation, as evidenced by the ipsilateral location of the abscess. This highlights the potential for serious intracranial infections to originate from the exfoliation of a deciduous tooth in healthy children, particularly those with orthodontic appliances.