PMC10323790_01
PMC10323790_02
Volume Rendering Technique of cranial CT scan demonstrating alveolar bone loss and significant dental degradation.
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F1
Also, the general clinical and oral examination of the patient, revealed only significant dental degradation (Fig. 1) and a significant loosening of the teeth 25/26/37 due to his very poor dental hygiene.
PMC10323790_03
(a): Axial section in T2 sequence showing hypo-isointense content and a significant oedema around the mass. (b) Axial slice T1sequence +contrast showing a mass with regular contours and homogeneous wall enhancement.
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F2
When the patient was hospitalized, brain magnetic resonance imaging (MRI) showed a lesion with hyper-/isointense-T2 fluid content and diffusion-restricting (Fig. 2a). The walls of the lesion appeared relatively regular and homogeneously enhanced (Fig. 2b), allowing us to conclude, as a first hypothesis in the presence of an abscess of the right posterior junction (Fig. 3).
PMC10323790_04
Collection of brain abscess showing sulphur granules.
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F4
Concerning the microbiology, macroscopic analysis showed the presence of sulphur granules viewable on the collection tube, suggesting the presence of a bacterium of the actinomycetal family (Fig. 4).
PMC10323790_05
Collection of brain abscess showing sulphur granules.
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F4
Concerning the microbiology, macroscopic analysis showed the presence of sulphur granules viewable on the collection tube, suggesting the presence of a bacterium of the actinomycetal family (Fig. 4).
(a): Gram-staining suggestive of 

Fusobacterium

 sp. (b): Gram-staining suggestive of 

Actinomyces

 sp.
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F5
Rare spindle-shaped Gram-negative bacilli suggestive of   Fusobacterium   sp. (Fig. 5a), as well as rare Gram-positive cocci and fine pleomorphic, branched Gram-positive bacilli consistent with   Nocardia   sp. or   Actinomyces   sp. were observed as in crushed granules (Fig. 5b).
(a): Hematoxylin and Eosin staining suggestive of 

Actinomyces

 sp. (b): Grocott staining suggestive of 

Actinomyces

 sp.
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F6
Rare colonies of   Actinomyces   sp. were found in the centre of some cavities (Fig. 6).
Post-operative brain contrast-enhanced computed tomography demonstrating the ventriculitis.
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F7
During the hospitalization in intensive care, a massive ventriculitis progressively appeared and was refractory to attempts of external shunting and antibiotic therapy (Fig. 7).