levetiracetam and Brain-Abscess

Odontogenic infections are quite common and, in unusual cases, can extend beyond the oral cavity with potentially life-threatening complications.. A 35-year-old woman, G3P0020, underwent extraction of an infected left maxillary third molar tooth at 19 3/7 weeks of gestation and later presented with mental status changes. Computed tomography revealed left pterygoid muscle abscess, which progressed to brain abscess. She underwent multiple partial lobectomies to drain her recurrent brain abscess. The pregnancy continued until term, and she underwent a cesarean delivery.. Brain abscess is a rare but life-threatening complication of pregnancy. This case illustrates the potential complications after extraction of an infected tooth in pregnancy.

Topics: Adult; Anti-Bacterial Agents; Anticonvulsants; Brain Abscess; Cefotaxime; Cesarean Section; Dexamethasone; Drug Therapy, Combination; Female; Focal Infection, Dental; Humans; Infant, Newborn; Levetiracetam; Male; Meningoencephalitis; Metronidazole; Molar, Third; Piracetam; Pregnancy; Pregnancy Complications, Infectious; Radiography; Streptococcal Infections; Tooth Extraction; Treatment Outcome; Ultrasonography, Prenatal; Viridans Streptococci

Topics: Adult; Agammaglobulinemia; Anticonvulsants; Brain Abscess; Humans; Immunoglobulins; Levetiracetam; Male; Piracetam; Seizures

In the treatment of seizures and epilepsy associated with central nervous system (CNS) infections, drug-drug interactions may significantly and unexpectedly impact outcome not only of epilepsy but also of the infectious disorders in both emergent and chronic care situations. A case is described in whom, the administration of the antimicrobial agent, meropenem presumably reduced serum valproate concentrations resulting in impaired seizure control. Other situations are reviewed in which interactions between antiepileptic drugs (AEDs) and antimicrobial agents may be of clinical significance. These include: (1) seizure management in individuals with neurocysticercosis, (2) management of seizures in patients with lobar tuberculomas, (3) management of seizures due to cerebral abscess, and (4) management of seizures in HIV-seropositive individuals.

Topics: Aged; Anti-Infective Agents; Anticonvulsants; Brain Abscess; Drug Interactions; Epilepsy; Female; Heart Block; HIV Infections; Humans; Levetiracetam; Neurocysticercosis; Piracetam; Valproic Acid