Human bite as the etiology of a rare case of enterococcus faecalis cerebral abscess

Abstract Background Brain abscesses are a devastating neurological condition usually seen in children in developing countries. Brain abscesses from human bites are however, uncommon, and more uncommon are brain abscesses with Enterococcus faecalis (E. faecalis) as the offending agent. Case presentation The index case was a 7-year-old boy referred from a peripheral hospital with a headache, low-grade fever of 5 days, and a forehead wound of 2 weeks following an inadvertent bite on the forehead by a classmate while playing on the school field. He was fully conscious, with a healing transverse forehead wound. CT Scan showed a huge right frontal smooth thin ring-enhancing lesion and midline shift. A diagnosis of right frontal cerebral abscess following a human bite was made. He had an urgent burr-hole and aspiration. Culture revealed E. faecalis, and was placed on antibiotics. The postoperative period was uneventful, and follow-up imaging showed complete resolution. He remained stable at 6 months follow-up. Conclusion Inadvertent human bites to the head can cause cerebral abscess, and even rarely, an oral commensal like E. faecalis can be the offending organism. A high index of suspicion is required, and proper management of human bites is important to prevent this kind of complication.