Brain abscess caused by Parvimonas micra: A rare case report and literature review

Brain abscesses mostly develop due to direct infection caused by a nearby infectious lesion or hematogenous spread and are rarely caused by an odontogenic infection. We report a 47-year-old woman who presented with high fever, disturbed consciousness, headache, and neck pain. Imaging studies revealed a ring-shaped enhanced mass in the left frontal lobe causing a mass effect and midline shift. Magnetic resonance spectroscopy revealed a peak alanine concentration of 1.5 ppm. Supraorbital keyhole surgery with abscess removal was performed, and a bacterial culture confirmed a diagnosis of Parvimonas micra infection. After undergoing 6-week antibiotic treatment, the patient's symptoms resolved completely. No recurrence of abscess was observed during the follow-up period. Although brain abscess caused by P. micra has rarely been reported, an odontogenic origin should be investigated, especially when a patient has a history of periodontal infection or tooth extraction.