Brain abscess following right maxillary odontogenic infection in a patient with diabetes mellitus: a case report

Odontogenic infections are common in the oral and maxillofacial region but rarely progress to life-threatening intracranial complications such as brain abscess. We report a rare case of a right maxillary odontogenic infection leading to a brain abscess in a previously undiagnosed, uncontrolled diabetic patient. A 42-year-old male presented with facial swelling and pain after endodontic treatment of the right maxillary premolars and molars. Initial improvement was achieved with incision, drainage, and antibiotic therapy; however, neurological deterioration occurred within days. Imaging revealed a right temporal lobe abscess, and Klebsiella pneumoniae was isolated from earlier blood and sinus cultures. The patient required multiple neurosurgical and maxillofacial interventions during a 106-day hospitalization. This case underscores the potential for rapid intracranial spread of odontogenic infections in immunocompromised hosts and highlights the importance of early neuroimaging and aggressive management in high-risk patients.