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PubMed1979

Assessment of the postoperative course of excised brain abscess by computerized tomography.

We present two patients with brain abscess who underwent complete excision with a satisfactory clinical outcome although serial computerized tomography (CT) Scans in the early postoperative period seemed to indicate a large residual abscess in each case. We recommend treatment based on the clinical course rather than the CT scan appearance, indicate that earlier reports on this topic may be misleading, and suggest an explanation for these findings.

Brain Abscess↗
PubMedDate not supplied

Salmonella meningitis complicated with subdural empyema, brain abscess and purpura fulminans: report of one case.

There exists high incidence of bacteremia, sepsis and meningitis in young infants with Salmonella infection. However, focal intracranial abscesses due to Salmonella infections are rare. We reported a 2-month-old male baby presenting salmonella infection with brain abscess and purpura fulminans. The patient's clinical course was fulminant. He was admitted due to fever, irritability, anemia and leukopenia. He developed cardiac arrest, shock and skin diathesis on his second hospitalization day. After resuscitation he became comatous and showed acrocyanosis and gangrenous skin over the hands, feet and left ear lobe. Both blood and cerebrospinal fluid cultures were Salmonella Group B. The patient got worse rapidly in spite of vigorous treatment. Subdural empyema, ventriculitis and later brain abscess were detected by serial brain sonograms. He died of central nervous system failure, gastrointestinal bleeding and renal failure on the eighteenth hospitalization day.

Brain Abscess↗
PubMed2002

Dialister pneumosintes associated with human brain abscesses.

In this report, we review two cases of brain infection due to Dialister pneumosintes in previously healthy patients. The bacterium was isolated from the first patient by blood culture and directly from a brain abscess in the second patient. In both cases, the infection was suspected to be of nasopharyngeal or dental origin. The patients had favorable outcomes following surgical debridement and antibiotic treatment. After in vitro amplification and partial sequencing of the 16S rRNA gene, two strains were classified as D. pneumosintes. However, traditional biochemical tests were not sufficient to identify the bacteria. In addition to causing periodontal and opportunistic infections, D. pneumosintes, contained in mixed flora, may behave as a clinically important pathogen, especially in the brain. In addition to phenotypic characterization, 16S rRNA partial sequencing was used to identify D. pneumosintes definitively.

Adolescent↗
PubMedDate not supplied

[The clinical picture and differential diagnosis of rhinosinogenic brain abscesses].

Some specific features of the course of rhinosinogenic brain abscesses (RBA) in adults and children were distinguished on the basis of analysis of the clinical data in 49 patients. RBA is encountered more frequently among adults and rarely among children, especially those of young age. In adults RBA are mostly consequent upon chronic frontitis or polysinusitis, while in children they occur after maxillary sinusitis, and in young children also after acute purulent processes in the nasal cavity. The contact route of infection of the cranial cavity and solitary abscesses are usually encountered in adults, and the hematogenous-metastatic route in children with the formation of solitary RBA and, in many cases, of multiple and multichamber abscesses. In children the abscesses grow to a large size. The hypertension syndrome is clearly defined in adults, while the hydrocephalus-hypertension syndrome comes to the forefront in children. The infectious-toxic symptoms are more marked in children. Focal neurologic symptomatology is manifested more markedly in adults and is less marked and labile in children.

Adolescent↗
PubMed1990

Perifocal brain oedema in experimental brain abscess in rats.

An experimental cerebral abscess model in which staphylococcus aureus was inoculated into the brain parenchyma of rats was evaluated for perifocal brain oedema. Blood-brain barrier permeability was studied using various kinds of tracers; sodium fluorescein as a small molecule and Evans blue and HRP as macromolecular tracers. Brain abscess with clear delineation of fibrous capsule formation were found in all animals. Extravasation of tracers was demonstrated in the capsule (Evans blue), extracellular space (HRP) and white matter (sodium fluorescein). There were two types of oedema formation, so called vasogenic oedema and cytotoxic brain oedema.

Animals↗
PubMed2000

Management of brain abscesses with sequential intravenous/oral antibiotic therapy.

Eight patients with brain abscesses who refused prolonged hospitalisation were treated with a short course (6-12 days) of intravenous antibiotics followed by prolonged treatment (15-19 weeks) with an oral antibiotic regimen consisting of metronidazole, ciprofloxacin and amoxicillin. All patients responded favourably as shown clinically and in imaging studies. No severe adverse events or sequelae were noted. On admission all patients had a normal or mildly impaired mental status, abscesses less than 3 cm in diameter and no serious predisposing factors. Although combined surgical/medical treatment remains the standard approach in management of these patients, the findings suggest that oral antibiotic therapy only subsequent to a short course of intravenous antibiotics may be an acceptable alternative in selected cases.

Administration, Oral↗
PubMed2006

Brain abscess associated with multidrug-resistant Capnocytophaga ochracea infection.

Brain abscesses are occasionally associated with a dental source of infection. An unusual case of frontal lobe abscess in a nonimmunocompromised child infected with multidrug-resistant Capnocytophaga ochracea is described and confirms the pathogenic potential of this organism to cause human disease in the central nervous system.

Anti-Bacterial Agents↗
PubMed2001

An unusual case of neonatal brain abscess following Klebsiella pneumoniae septicemia.

A case of solitary brain abscess in a term neonate caused by Kiebsiella pneumoniae is described. K. pneumoniae, although a common cause of neonatal septicemia, is rarely implicated as an etiological agent for cerebral abscess in this age-group. The interest of this case lies in the rarity of the causative organism and atypical features. In the absence of predisposing factors in the neonate, we suspect that the infection was transmitted vertically from the mother before or at the time of delivery since there was evidence of asymtomatic urinary tract infection in the antenatal period.

Adult↗
PubMed1994

Expression of basic fibroblast growth factor, nerve growth factor, platelet-derived growth factor and transforming growth factor-beta in human brain abscess.

We correlated the histopathological findings of six human brain abscesses with the expression of basic fibroblast growth factor (bFGF), nerve growth factor (NGF), platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF beta). The clinical courses ranged from 1 month to 1 year and viridans streptococcus was the major pathogen. In early abscesses, we demonstrated strong bFGF and moderate NGF and PDGF immunoreactivities in neutrophils and monocytes/macrophages infiltrating the abscess wall and in the fibrin layer lining the abscess center. In the subacute cases, growth of capillaries and fibroblasts into the fibrin layer and deposition of collagen resulted in the formation of a mesodermal layer between the abscess center and the outer gliotic layer. The proliferative non-neural cells (endothelial cells, fibroblasts and glial cells) expressed mild to strong bFGF, NGF and PDGF immunoreactivities, while strong TGF beta staining was seen in the extracellular matrix. A loss of growth factor expression and increased fibrosis was seen in the chronic case. These findings suggest that bFGF, NGF, PDGF and TGF beta produced by the continued influx of leukocytes and by the proliferating non-neural cells may mediate various steps of defense mechanisms and wound healing such as angiogenesis, fibrogenesis and gliosis.

Antibody Specificity↗
PubMed1999

Neurosurgical management of brain abscesses in children.

The authors review the management of brain abscesses (BAbs) in 59 pediatric cases. The major surgical procedure used to treat them was repeated puncture and aspiration (51 cases, or 86.44%), excision (8 cases - 13.56%) being of secondary importance. The main etiology was metastatic lesions (24 cases - 40.68%), those due to cyanotic congenital heart disease being the most frequent. Single lesions dominated (41 cases - 69.49%). Gram-positive cocci were the main bacteria involved (31 cases, 52.5%). CT scan represented the main tool in the diagnosis and follow-up. Puncture and aspiration in BAbs led to a significant decrease in mortality (7 cases - 11.86%), and the incidence of seizures and neurological deficits was also reduced. Mortality was significantly correlated with the following factors: consciousness status, multiple BAbs location and hematogenous dissemination. There were recurrences in 11 cases (18.64%), all observed after aspiration procedures. The current concepts for complex management of BAbs, as reflected in recent literature data, are reviewed, with particular emphasis on the use of real-time CT or ultrasound-guided operative techniques.

Brain Abscess↗
PubMed1977

Feline brain abscesses due to Cladosporium trichoides.

Cladosporium trichoides was isolated from brain abscesses of two cats. No obvious route of entry was found in either case. The brain was the only organ cultured. No other significant lesions were observed during necropsy. These are the first reported cases of such infection in animals.

Animals↗
PubMed1976

Lactate dehydrogenase and aspartete transaminase of the cerebrospinal fluid in patients with brain tumours, congenital hydrocephalus, and brain abscess.

The diagnostic value of CSF lactate dehydrogenase and aspartate transaminase in cases of brain tumours (except for CSF AST in the benign tumours), congenital hydrocephalus, and brain abscess is established. Tumour cyst fluids show a higher enzymatic activity than does the CSF. The two enzyme estimations do not help in differentiating the supratentorial from the infratentorial tumours. CSF AST is superior to CSF LD in discriminating the malignant and benign tumours, in so far as the AST is increases selectively in malignancy. Estimates of CSF LD are slightly superior to those of CSF AST, both in incidence of abnormality and the degree of their rise.

Aspartate Aminotransferases↗
PubMed1998

Brain abscess as the presenting feature of melioidosis.

Central nervous system involvement in melioidosis is rare and there are only a few reports of the causative organism, Burkholderia pseudomallei, causing a brain abscess. We report a patient who presented to us with a brain abscess due to this organism and emphasize the need for a high degree of suspicion for this disease in tropical countries and treatment with the appropriate antibiotics, as the mortality associated with this disease is very high.

Adult↗
PubMed1995

Candidal brain abscess associated with vascular invasion: a devastating complication of vascular catheter-related candidemia.

We describe a patient who developed Candida albicans brain abscess associated with prominent vascular invasion following an episode of central venous catheter-related fungemia. The increasing population of immunosuppressed patients and the frequent use of broad-spectrum antimicrobials, corticosteroids, chemotherapeutics, organ transplantation, and prolonged supportive measures are responsible for an increasing incidence of candidal infections. Brain abscess is a rare complication of candidemia but may be expected to become more common as venous catheter-related fungemia is encountered more frequently.

Amphotericin B↗
PubMed1996

Sudden "stroke-like' onset of homonymous hemianopsia due to bacterial brain abscess.

A previously healthy 40-year-old man experienced the sudden 'stroke-like' onset of homonymous hemianopsia due to a bacterial brain abscess. Clinical features and initial computed tomography (CT) suggested a stroke. Subsequent CT and magnetic resonance (MR) demonstrated a cerebral abscess, proven at surgery. It is extremely rare that a healthy individual without various risk factors, such as congenital heart disease, immunologic deficiency, diabetes mellitus, or pregnancy, presents with the above symptoms. The exact mechanism of this sudden 'stroke-like' onset in a patient with a bacterial brain abscess is unknown. One possibility is that paroxysmal septic emboli led to abscess formation within or near areas of embolic infarction. Another possibility is that a primary cerebral infarction was associated with secondary bacteremia. Surgical drainage revealed a bacterial (Streptococcus) abscess, but no identifiable source of infection.

Adult↗
PubMed2006

[Cord blood transplantation after successful treatment of brain abscess caused by Bacillus cereus in a patient with acute myeloid leukemia].

Central nervous system infection caused by Bacillus cereus is a rare condition, which often progresses rapidly and is fatal in immunocompromised patients. A 54-year-old woman with acute myelogenous leukemia fell into a coma with high fever during severe neutropenia while undergoing chemotherapy. A blood culture demonstrated the presence of B. cereus and magnetic resonance imaging showed multiple abnormal lesions in her brain. The patient was treated with meropenem and vancomycin, and recovered from the coma in a week. Antibiotic therapy was administered for seven weeks, and then she underwent cord blood transplantation for refractory acute myelogenous leukemia with successful engraftment without exacerbation of the brain abscess. This case demonstrates that brain abscess caused by B. cereus can be treated without surgical treatment.

Bacillus cereus↗