Giant Frontal Brain Abscess Due to Streptococcus Viridans in an 8-Year-Old Patient: Case Report

A brain abscess is defined as an encapsulated lesion of the central nervous system. It is an infrequent occurrence, particularly in the pediatric population with no relevant history. There are multiple routes of infection, but in pediatrics, inoculation by contiguity or hematogenous infection under specific conditions predominates. We present the clinical case of an 8-year-old male patient with no relevant personal or family history. The patient presented with a nonspecific clinical picture of intermittent headaches that had been evolving for 2 months. There were no ostensible neurological alterations. A normal physical examination was conducted on admission. However, a giant brain abscess in the frontal lobe was identified by brain computed tomography. The only potential cause that could be identified was an odontogenic origin. The patient was approached by the neurosurgery team, who proceeded to empty the abscess capsule. A brain secretion culture was also conducted, which yielded isolation of Streptococcus viridans. It is established that this etiological agent is of very low virulence and rarely produces symptoms in immunocompetent patients, representing a low disease burden. However, in the event of infection, it can have severe repercussions. It is noteworthy that the patient did not present positive acute phase reactants, no positive blood tests, and no other relevant findings were evidenced despite the large mass effect and edema evidenced in the neuroimages taken.