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PubMed1999

[Brain abscess following the use of skull traction with Gardner-Wells tongs].

Brain abscess after insertion of skull traction is a rare and serious complication. Its development is secondary to superficial infection. Adequate preventive measures have to be taken: proper sterile dressing and daily care. Signs of local irritation are not always synonymous with skull migration. When gradual loosening of the skull occurs, especially associated with superficial infection, the pins must not be tightened. The more appropriate management is to investigate for penetration of the inner cranial cave. When in doubt, repositioning the pins may be necessary, as well as establishing an aggressive treatment against cutaneous infection.

Adult↗
PubMed1994

[A case of brain abscess associated with enterococcal endocarditis].

Enterococcal infections involving the central nervous system are uncommon clinical entities. A 74-year-old male was admitted to our hospital on November 3, 1991 for high fever. Nuchal rigidity was observed at neurological examination. All four blood cultures yielded E. faecalis. The MIC value of ABPC against the isolated E. faecalis was 0.25 microgram/ml. Vegetation on the mitral valve and mitral regurgitation were revealed by an echocardiogram. Enhanced CT scan showed low density area with ring enhancement in the right basal ganglia and a CSF examination suggested bacterial meningitis. He became better after ABPC 8 g/day was intravenously administered. Then the vegetation on the mitral valve and the brain abscess disappeared. He was discharged with no complications. We reported a rare case of brain abscess associated with enterococcal endocarditis.

Aged↗
PubMed1972

Brain abscess due to Haemophilus aphrophilus: case report.

A temporal lobe abscess due to H. aphrophilus occurred in a child of 11 years, and was successfully treated by aspiration, chemotherapy, and excision of the abscess wall. The organism is an unusual cause of brain abscess and this is believed to be the first reported case in Britain.

Ampicillin↗
PubMed2005

[A case of multiple brain abscess effectively markedly responded to high dose panipenem/betamipron administration].

A 54-year-old, previously healthy female experienced headache, nausea and vomiting, and consulted our hospital regarding her symptoms. Her cerebrospinal fluid (CSF) showed leukocytosis with polymorphonucleosis and hypoglycemia, thus she was diagnosed with bacterial. She admitted to our hospital and combination therapy of ampicillin and cefotaxime was started. CSF and blood cultures was negative. On the third hospital day, despite a decrease in her CSF cell count, her consciousness level decreased and neck stiffness worsened. On the seventh hospital day, the CSF cell count increased again, and we changed antibiotics to panipenem/betamipron (PAPM/BP) at 4 g/day. On the tenth hospital day, the CSF cell count decreased, but by the twelfth hospital day her consciousness had deteriorated to a drowsy state. Brain CT and MRI revealed multiple brain abscesses and hydrocephalus. We increased the dose of PAPM/BP up to 8 g/day, and her neurological, CSF and brain MRI findings subsequently improved. The patient was discharged from our hospital on the sixty-ninth hospital day. As the frequency of beta-lactamase-producing bacteria is currently increasing, carbapenems should be considered as first choice of antibiotics for the initial treatment of multiple brain abscess.

Anti-Bacterial Agents↗
PubMed1986

[Effect of hydrocortisone on changes in brain tissue in experimental brain abscess and leptomeningitis].

A total of 286 rats were involved in an experiment, with 123 of them being control and 153 receiving daily injections of hydrocortisone (H) in a dose of 3 mg per 100 g body weight. Ten rats were intact. With regard to CNS changes 2 periods were identified in H-treated rats with experimental brain abscess and leptomeningitis: the first was characterized by the effect of the hormone at the acute period of the disease (3-7 days), the second by its action following the long-term administration (15-30 days). In the first 7 days, by reducing the inflammatory reaction, water-electrolyte disturbances and the activity of acid and alkaline phosphatases in the cerebral tissue, as well as by increasing the RNA synthesis in neurons, H prevented the dissemination of the process into the surrounding tissue, swelling and edema, expedited wound clearance and helped to reduce the mortality rate. The use of H for 10-30 days led to the tigrolysis of neurons, elevation in the activity of acid and alkaline phosphatases and brain edema, as well as to a reduction in DNA levels in neurons and a dramatic rise in the mortality rate. The findings indicate the advisability of H utilization in the treatment of brain abscess and leptomeningitis only in the acute period of the disease and as a short course.

Animals↗
PubMed1993

[Amebic brain abscess. Apropos of a case].

We report a case of double primary amoebic brain abscess in a 22 year old man, with signs of intracranial hypertension and deficit. Computed tomography found two hypodense lesions, not suggestive of pyogenic abscesses. Aspiration of one of the two abscesses, revealed the organism, and the two abscesses regressed in response to medical treatment. The authors insist on the rarity of these abscesses, their gravity, and the difficulty of the diagnosis.

Adult↗
PubMedDate not supplied

[Computed tomography in the diagnosis of brain abscesses in children].

The findings of computed tomography in 27 children aged from 4 months to 15 years with abscesses of the brain are analysed. Computed tomography proved to be an informative diagnostic method in determining the exact topography, size, and shape of the abscess. It allows judgement of the efficacy of nonoperative and surgical management of abscesses.

Adolescent↗
PubMedDate not supplied

Brain abscess as a rare complication in a hemodialysed patient.

BACKGROUND: Infections remain among the most common morbid events and are an important cause of death in end stage renal disease. They have reduced immune response and increased hazard of infections due to repeated puncture of an arterio-venous fistula, formation of haematoma at the site of cannulation and central vein catheterisation. CASE REPORT: We report a case of brain abscess in chronically haemodialysed patient admitted to our department due to haedache, vomiting, accelerated hypertension and fever. The clinical examination revealed narroving of the right palpebral slit, weeping and right oral angle hanging loose. He had mild microcytic anaemia and high level of g-globulin. Ophtalmologic examination showed normal oculi fundi. The computed tomography revealed heterogenous mass marginally enhanced with contrast agent in the right frontal cerebral lobe. The right fronto-temporal craniotomy was performed and the right frontal lobe abscess was found and totally excised. The postoperative course was uneventful besides of seizures which were effectively treated with carbamazepine. After bilateral nephrectomy the patient undervent succesfull kidney transplantation and is in good condition without any neurological defect. A probable cause of his brain abscess was peridontal abscess recognized 3 month earlier or bilateral vesicoureteral refluxes. CONCLUSIONS: 1. Uremic patients have a reduced immunocapacity and are a high risk group for infections of various etiology. 2. Prompt eradication of all sources of infection is essential in hemodialysed patients.

Adult↗
PubMed1999

[Successful treatment for disseminated intra-vascular coagulation due to sepsis and brain abscess with low molecular weight heparin in a patient with antiphospholipid syndrome].

The management of disseminated intravascular coagulation (DIC) in a 22-year-old female patient with antiphospholipid syndrome is reported. Gabexate mesilate was given by continuous drip infusion at 1.5 g/day. No effect was seen, therefore Dalteparin sodium (DS) was administered by continuous drip infusion at 70 U/kg/day. The DIC score improved gradually during the first 4 days to normalization by 10 days. However, convulsive seizure was developed. Computed tomographic scan of brain demonstrated brain abscess at lt-basal ganglia. Continuous drainage was performed while administered continuous drip infusion of DS. Follow-up CT after operation showed reduction of low density area which means brain abscess. Finding in this case suggest that DS may play a role in the management of DIC accompanying intracranial infection.

Adult↗
PubMed1990

Brain abscess and congenital heart disease.

One hundred and thirty-three cases of brain abscess over a period of 20 years (1967-1986) were reviewed and 25 (18.7%) of these were associated with congenital heart disease (CHD). Headache was the predominant clinical feature and anaerobic streptococci were the commonest pathogen isolated. Craniotomy and excision of the abscess and burrhole aspiration were the mainstay of treatment together with appropriate antibiotic therapy. The importance of early diagnosis and treatment had been highlighted and the relative merits of the two methods of treatment were discussed.

Adolescent↗
PubMed2003

Brain abscesses as a metastatic manifestation of strangles: symptomatology and the use of magnetic resonance imaging as a diagnostic aid.

REASONS FOR PERFORMING STUDY: The occurrence of unexpectedly high numbers of horses with neurological signs during two outbreaks of strangles required prompt in-depth researching of these cases, including the exploration of magnetic resonance imaging (MRI) as a possible diagnostic technique. OBJECTIVES: To describe the case series and assess the usefulness of MRI as an imaging modality for cases suspected of space-occupying lesions in the cerebral cavity. METHODS: Four cases suspected of suffering from cerebral damage due to Streptococcus equi subsp. equi infection were examined clinically, pathologically, bacteriologically, by clinical chemistry (3 cases) and MRI (2 cases). In one case, MRI findings were compared to images acquired using computer tomography (CT). RESULTS: In all cases, cerebral abscesses positive for Streptococcus equi subsp. equi were found, which explained the clinical signs. Although the lesions could be visualised with CT, MRI images were superior in representing the exact anatomic reality of the soft tissue lesions. CONCLUSIONS: The diagnosis of bastard strangles characterised by metastatic brain abscesses was confirmed. MRI appeared to be an excellent tool for the imaging of cerebral lesions in the horse. POTENTIAL CLINICAL RELEVANCE: The high incidence of neurological complications could not be explained but possibly indicated a change in virulence of certain strains of Streptococcus equi subsp. equi. MRI images were very detailed, permitting visualisation of much smaller lesions than demonstrated in this study and this could allow prompt clinical intervention in less advanced cases with a better prognosis. Further, MRI could assist in the surgical treatment of brain abscesses, as has been described earlier for CT.

Animals↗
PubMed2003

Intraventricular rupture of Nocardia brain abscess--case report.

A 71-year-old male presented with left hemiparesis and confused conversation. Computed tomography showed a mass lesion with rim enhancement in the right parietal lobe. He developed meningeal irritation the day after admission. Emergent fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) imaging revealed a clear hyperintense component in the right lateral ventricle and niveau formation inside the intracerebral lesion, indicating intraventricular rupture of the brain abscess. The patient underwent aspiration of the abscess and ventricular drainage with antibiotic administration. Nocardia asteroides was isolated from the aspirated pus, so systemic and direct administration of effective antibiotics was subsequently commenced. These procedures resulted in gradual improvement of his clinical course, and he left our hospital. Several days after discharge, he developed acute pan-peritonitis due to malignant lymphoma. He appeared to be progressively deteriorating after an exploratory laparotomy, and died on the 17th day after the laparotomy. Intraventricular rupture of nocardia brain abscess can be successfully treated after early definitive diagnosis with FLAIR MR imaging.

Abdominal Pain↗
PubMed1984

Bilateral brain abscesses. Report of 2 cases.

This is a report about two cases with bilateral brain abscesses, who will be extirpated with success. The preoperative treatment with antibiotics was without success. CT-control demonstrated the complete removal of both abscesses. The surgical treatment may be indicated in patients affected by supratentorial bilateral cerebral abscesses.

Adult↗
PubMed1970

Cerebral candidiasis: case report of brain abscess secondary to Candida albicans, and review of literature.

A patient with a brain abscess due to Candida albicans is reported. This patient had three episodes of systemic candidiasis in spite of the fact that she had no underlying debilitating disease and had never received prior antibiotic or adrenocortical steroid therapy. A review of the literature reveals 42 cases of central nervous system Candida albicans infection. The salient features of these cases are tabulated and discussed. The clinical features, pathology, pathogenesis, treatment, and aetiology of cerebral candidiasis are also discussed.

Adult↗