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Abcesso cerebral de origem dentária: revisão integrativa
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Abstract(s)
Os abscessos cerebrais de origem dentária são uma condição médica rara, mas potencialmente grave, que pode ocorrer quando bactérias associadas a uma infecção dentária conseguem entrar na corrente sanguínea ou espalhar-se diretamente pelos tecidos da cabeça e do pescoço, alcançando eventualmente o cérebro. Esta progressão bacteriana em direção ao cérebro pode ocorrer de diversas maneiras, incluindo a disseminação através dos espaços fasciais da cabeça ou a extensão direta a partir da região oral ou maxilofacial. Um abcesso cerebral é uma condição crítica que resulta na formação de pus e afeta o tecido cerebral, podendo levar a danos permanentes e até mesmo à morte. Portanto, é fundamental procurar tratamento médico imediato ao suspeitar de um abcesso cerebral de origem dentária para evitar complicações graves. O objetivo principal desta tese é identificar as bactérias da cavidade oral responsáveis pelos abscessos cerebrais, determinar os mecanismos utilizados por estes microrganismos para a sua propagação até ao cérebro e indicar estratégias de prevenção destas infeções. Além disso, é importante destacar o papel do médico dentista na prevenção destes abcessos e os tratamentos disponíveis. Este trabalho pretende combinar dados da literatura empírica e teórica de forma a reunir e sintetizar resultados de várias pesquisas sobre o tema proposto. Entre as bactérias envolvidas, Streptococcus intermedius emergiu como uma das principais responsáveis, embora outras espécies também possam contribuir para esses quadros clínicos complexos. A trajetória destas bactérias, desde infeções dentárias comuns até abcessos cerebrais, é um exemplo claro da interconectividade entre diferentes sistemas do corpo humano. A disseminação destes microrganismos pode ocorrer de várias maneiras, seja através de trajetos contíguos, atingindo estruturas cranianas adjacentes, ou através de sistemas vasculares e linfáticos menos frequentes, mas não menos preocupantes. Ao longo deste trabalho, verificou-se que a bactéria Streptococcus intermedius é frequentemente implicada em casos de abscessos cerebrais de origem dentária. No entanto, outras espécies bacterianas também podem estar envolvidas nestes quadros clínicos, mostrando a complexidade destas infeções. A disseminação das bactérias da cavidade oral até ao cérebro pode ocorrer através de várias vias, incluindo a contiguidade direta para estruturas cranianas adjacentes e a propagação através dos sistemas vascular e linfático. O entendimento dos mecanismos de disseminação bacteriana é crucial para desenvolver estratégias de prevenção e tratamento. A prevenção eficaz destas infeções depende em grande parte do papel do médico dentista, que deve estar vigilante para sinais de infeção dentária que possam potencialmente evoluir para condições mais graves, como os abscessos cerebrais. A adoção de práticas rigorosas de higiene oral, juntamente com o tratamento precoce de infeções dentárias, pode reduzir significativamente o risco de desenvolvimento de abscessos cerebrais. Além disso, a integração de dados da literatura empírica e teórica permite uma compreensão mais abrangente e detalhada das bactérias envolvidas e dos mecanismos de propagação, fornecendo uma base sólida para futuras pesquisas e melhorias nas práticas clínicas.
Brain abscesses of dental origin are a rare but potentially serious medical condition that can occur when bacteria associated with a dental infection manage to enter the bloodstream or spread directly through the tissues of the head and neck, eventually reaching the brain. This bacterial progression toward the brain can occur in various ways, including dissemination through the fascial spaces of the head or direct extension from the oral or maxillofacial region. A brain abscess is a critical condition that results in pus formation and affects brain tissue, potentially leading to permanent damage and even death. Therefore, it is essential to seek immediate medical treatment if a brain abscess of dental origin is suspected to avoid serious complications. The main objective of this thesis is to identify the bacteria in the oral cavity responsible for brain abscesses, determine the mechanisms used by these microorganisms to spread to the brain, and suggest strategies for preventing these infections. Additionally, it is important to highlight the role of the dentist in preventing these abscesses and the available treatments. This work aims to combine data from empirical and theoretical literature to gather and synthesize results from various research studies on the proposed topic. Among the bacteria involved, Streptococcus intermedius has emerged as one of the main culprits, although other species may also contribute to these complex clinical scenarios. The trajectory of these bacteria, from common dental infections to brain abscesses, is a clear example of the interconnectedness between different systems of the human body. The dissemination of these microorganisms can occur in various ways, either through contiguous routes reaching adjacent cranial structures or through less common but no less concerning vascular and lymphatic systems. Throughout this work, it was found that the bacterium Streptococcus intermedius is frequently implicated in cases of brain abscesses of dental origin. However, other bacterial species may also be involved in these clinical scenarios, demonstrating the complexity of these infections. The dissemination of bacteria from the oral cavity to the brain can occur through various pathways, including direct contiguity to adjacent cranial structures and spread through vascular and lymphatic systems. Understanding the mechanisms of bacterial dissemination is crucial for developing prevention and treatment strategies. Effective prevention of these infections largely depends on the role of the dentist, who must be vigilant for signs of dental infection that could potentially evolve into more serious conditions, such as brain abscesses. Adopting rigorous oral hygiene practices, along with early treatment of dental infections, can significantly reduce the risk of developing brain abscesses. Furthermore, integrating data from empirical and theoretical literature allows for a broader and more detailed understanding of the bacteria involved and the mechanisms of spread, providing a solid foundation for future research and improvements in clinical practices.
Brain abscesses of dental origin are a rare but potentially serious medical condition that can occur when bacteria associated with a dental infection manage to enter the bloodstream or spread directly through the tissues of the head and neck, eventually reaching the brain. This bacterial progression toward the brain can occur in various ways, including dissemination through the fascial spaces of the head or direct extension from the oral or maxillofacial region. A brain abscess is a critical condition that results in pus formation and affects brain tissue, potentially leading to permanent damage and even death. Therefore, it is essential to seek immediate medical treatment if a brain abscess of dental origin is suspected to avoid serious complications. The main objective of this thesis is to identify the bacteria in the oral cavity responsible for brain abscesses, determine the mechanisms used by these microorganisms to spread to the brain, and suggest strategies for preventing these infections. Additionally, it is important to highlight the role of the dentist in preventing these abscesses and the available treatments. This work aims to combine data from empirical and theoretical literature to gather and synthesize results from various research studies on the proposed topic. Among the bacteria involved, Streptococcus intermedius has emerged as one of the main culprits, although other species may also contribute to these complex clinical scenarios. The trajectory of these bacteria, from common dental infections to brain abscesses, is a clear example of the interconnectedness between different systems of the human body. The dissemination of these microorganisms can occur in various ways, either through contiguous routes reaching adjacent cranial structures or through less common but no less concerning vascular and lymphatic systems. Throughout this work, it was found that the bacterium Streptococcus intermedius is frequently implicated in cases of brain abscesses of dental origin. However, other bacterial species may also be involved in these clinical scenarios, demonstrating the complexity of these infections. The dissemination of bacteria from the oral cavity to the brain can occur through various pathways, including direct contiguity to adjacent cranial structures and spread through vascular and lymphatic systems. Understanding the mechanisms of bacterial dissemination is crucial for developing prevention and treatment strategies. Effective prevention of these infections largely depends on the role of the dentist, who must be vigilant for signs of dental infection that could potentially evolve into more serious conditions, such as brain abscesses. Adopting rigorous oral hygiene practices, along with early treatment of dental infections, can significantly reduce the risk of developing brain abscesses. Furthermore, integrating data from empirical and theoretical literature allows for a broader and more detailed understanding of the bacteria involved and the mechanisms of spread, providing a solid foundation for future research and improvements in clinical practices.
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Keywords
Infeção dentária Abcesso cerebral Origem dentária Dental infection Brain abcess Dental origin