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<p>Brain abscesses are rare but life-threatening infections that may result from contiguous spread or hematogenous dissemination, with odontogenic infections being an important source. We report the first case from Turkey of a&#xa0;polymicrobial brain abscess caused by <i>Actinomyces meyeri</i> and <i>Fusobacterium nucleatum</i> in an immunocompetent 81-year-old male with poor oral hygiene and a&#xa0;history of untreated dental infection. The patient presented with headache and altered mental status, and neuroimaging revealed a&#xa0;right frontal abscess. Surgical excision was performed, and microbiological evaluation identified both pathogens by anaerobic culture and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, with susceptibility testing confirming sensitivity to β‑lactams and metronidazole. Notably, follow-up oral swab culture yielded <i>A.&#xa0;meyeri</i> with an identical susceptibility profile, supporting a&#xa0;dental origin of infection. The patient was successfully treated with surgical drainage and high-dose penicillin G&#xa0;combined with metronidazole followed by oral therapy, with no recurrence observed at 3&#xa0;months. This case emphasizes the role of odontogenic infections as a&#xa0;source of intracranial abscesses and highlights the importance of microbiological and molecular methods for accurate pathogen identification and therapeutic guidance.</p>

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A rare brain abscess caused by co-infection with Fusobacterium nucleatum and Actinomyces meyeri

  • 期刊论文

  • 发表日期：

    2026年1月13日

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  • Abdullah Tozluyurt,
  • Mustafa Caglar Sahin,
  • Alaeddin Acar

摘要

Brain abscesses are rare but life-threatening infections that may result from contiguous spread or hematogenous dissemination, with odontogenic infections being an important source. We report the first case from Turkey of a polymicrobial brain abscess caused by Actinomyces meyeri and Fusobacterium nucleatum in an immunocompetent 81-year-old male with poor oral hygiene and a history of untreated dental infection. The patient presented with headache and altered mental status, and neuroimaging revealed a right frontal abscess. Surgical excision was performed, and microbiological evaluation identified both pathogens by anaerobic culture and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, with susceptibility testing confirming sensitivity to β‑lactams and metronidazole. Notably, follow-up oral swab culture yielded A. meyeri with an identical susceptibility profile, supporting a dental origin of infection. The patient was successfully treated with surgical drainage and high-dose penicillin G combined with metronidazole followed by oral therapy, with no recurrence observed at 3 months. This case emphasizes the role of odontogenic infections as a source of intracranial abscesses and highlights the importance of microbiological and molecular methods for accurate pathogen identification and therapeutic guidance.