scholarly journals Stereotactic Management of Bacterial Brain Abscesses

1996 ◽  
Vol 23 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Sohrab Shahzadi ◽  
Andres M. Lozano ◽  
Mark Bernstein ◽  
Abhijit Guha ◽  
Ronald R. Tasker
Keyword(s):  
Mortality Rate ◽  
Antibiotic Therapy ◽  
Cerebral Hemispheres ◽  
Intravenous Antibiotic ◽  
Stereotactic Techniques ◽  
Stereotactic Aspiration ◽  
Tuberculous Abscess ◽  
Neurologic Disability ◽  
Bacterial Organism ◽  
Brain Abscesses

ABSTRACT:Background:CT and MR guided stereotactic techniques have provided promising results in the management of brain abscesses. We reviewed our results of stereotactic management of brain abscesses in 20 consecutive patients with 28 abscesses from 1986 to 1993.Methods:13 abscesses were in the cerebral hemispheres, 12 in the cerebellum, 2 in the pons and 1 in the thalamus. The bacterial organism was isolated in 12 of the 20 cases. All patients, except one who had a tuberculous abscess, were on antibiotics for less than 7 weeks.Results:Although there were 3 patients in coma before surgery, the mortality rate was zero and 17 patients had an excellent recovery with 3 patients having a persistent mild neurologic disability. Stereotactic aspiration of the largest lesion in the patients with multiple brain abscesses combined with intravenous antibiotic therapy was sufficient for the resolution of all lesions. Two of our patients treated with antibiotics alone showed abscess progression with neurologic worsening.Conclusion:Stereotactic aspiration is safe, accurate, and when combined with the appropriate antibiotics, should be considered the procedure of choice in the management of brain abscesses.

Cranial melioidosis presenting as a mass lesion or osteomyelitis

2008 ◽  
Vol 108 (2) ◽  
pp. 243-247 ◽  
Author(s):  
G. Samson Sujit Kumar ◽  
Promila Mohan Raj ◽  
Geeta Chacko ◽  
Mukkai K. Lalitha ◽  
Ari. G. Chacko ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Antibiotic Therapy ◽  
Burkholderia Pseudomallei ◽  
The Body ◽  
The Other ◽  
Stereotactic Aspiration ◽  
Brain Abscesses ◽  
Histopathological Studies ◽  
High Index Of Suspicion ◽  
Mass Lesions

Object Melioidosis is caused by Burkholderia pseudomallei and causes multiple abscesses in different organs of the body. Cranial melioidosis, although uncommon, is sometimes confused with tuberculosis and is therefore underecognized. The authors report on 6 cases of cranial infections caused by Burkholderia pseudomalleii, presenting as mass lesions or cranial osteomyelitis, and review the literature. Methods The authors performed a retrospective review of the records of patients with cranial melioidosis treated at their institution between 1998 and 2005 to determine the presentation, management, and outcome of patients with this infection. Results Of the 6 patients diagnosed with cranial melioidosis during this period, 4 had brain abscesses and 2 had cranial osteomyelitis. All patients were treated surgically, and a diagnosis was made on the basis of histopathological studies. All patients were started on antibiotic therapy following surgery and this was continued for 6 months. One patient died soon after stereotactic aspiration of a brain abscess, and the other 5 patients had good outcomes. Conclusions Cranial melioidosis is probably more prevalent than has been previously reported. A high index of suspicion, early diagnosis, initiation of appropriate antibiotic therapy and treatment for an adequate period are essential for assuring good outcome in patients with cranial melioidosis. The authors recommend surgery followed by intravenous ceftazidime treatment for 6 weeks and oral cotrimoxazole for 6 months thereafter in patients with cranial melioidosis.

scholarly journals Management of Intracranial Abscess - Study of 30 cases

1970 ◽  
Vol 16 (2) ◽  
pp. 73-75
Author(s):  
Md L Rahman ◽  
ML Rahman ◽  
S Hossain ◽  
ASMS Ali ◽  
SK Pramanik ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Diagnostic Tools ◽  
Intracranial Abscess ◽  
Multiple Abscess ◽  
Brain Abscesses ◽  
Burr Hole Evacuation ◽  
Made In

Brain abscess may be solitary or multiple. They appear as areas of ill-defined cerebritis tomature well defined focal suppurative lesion with capsulated abscesses. Multiple brain abscessrecognized in as many as 50% of patients. In this study 30 patients were analyzed. Solitary brainabscess were more than multiple abscess. Age ranges from 6 years to 35 years. Male to femaleratio was 5:1. Intra parenchymal brain abscess occurred in all cases (100%), subdural orextradural lesions were nil. Brain abscesses were associated with CSOM. CT scan done in all(100%) patients as diagnostic tools. All (100%) patients under went Burr-hole evacuation withbroad-spectrum antibiotic therapy and 2 patients (06.66%) treated with long term anti tuberculartherapy. V-P shunt was made in 1 patient (03.33%) who had persistent venriculomegaly. In thisstudy mortality rate was zero.doi: 10.3329/taj.v16i2.3887TAJ December 2003; Vol.16(2): 73-75

scholarly journals Brain Abscess of Otorhinolaryngologic Origin: Study of 80 Cases in the Neurosurgery Department of Conakry University Hospital Center

2021 ◽  
Vol 2 (2) ◽  
pp. 047-051
Author(s):  
BL Fatoumata ◽  
SI Sory ◽  
AH Ghislain ◽  
CA Youssouf ◽  
DH Abdoul Bachir ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Sex Ratio ◽  
Antibiotic Therapy ◽  
University Hospital ◽  
Entrance Door ◽  
Life Threatening ◽  
Brain Abscesses ◽  
The Mean ◽  
Hospital Center

Introduction: Brain abscesses are serious conditions that can be life-threatening if left untreated. The objective of our study was to determine the epidemiological, clinical, paraclinical, therapeutic and evolutionary characteristics of cerebral abscesses of otorhinolaryngological origin in our department. Methods and Materials: This was a retrospective study of 80 cerebral abscess files of otorhinolaryngological origin collected over a period of 5 years (January 2014-December 2018) at the neurosurgery department of Conakry University Hospital Center. Results: Abscesses of otorhinolaryngological origin represented 72% of all abscesses. The mean age was 14.7 years with a sex ratio of 4. The clinical picture was dominated by fever (92%), focal signs (55%) and intracranial hypertension (46%). The entrance door was 84% sinus. The frontal site was predominant, 44 cases. Eighty-two percent of patients underwent surgery and 18% were treated with antibiotic therapy alone. The evolution was favorable in 75% of the cases with a mortality rate of 15%. Conclusion: Brain abscesses are a medical-surgical emergency. The forms of otorhinolaryngologic origin are dominated by sinusitis. Despite the therapeutic difficulties, the prognosis remains acceptable in our study, 15% of deaths.

scholarly journals Brain Abscess Caused by Nocardia: Case Report and Literature Review

2020 ◽  
Author(s):  
Guilherme Finger ◽  
Maria Eduarda Conte Gripa ◽  
Tiago Paczko Bozko Cecchini ◽  
Tobias Ludwig do Nascimento
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Clinical Signs ◽  
Occipital Lobe ◽  
High Morbidity ◽  
Rare Clinical Entity ◽  
Brain Abscesses

AbstractNocardia brain abscess is a rare clinical entity, accounting for 2% of all brain abscesses, associated with high morbidity and a mortality rate 3 times higher than brain abscesses caused by other bacteria. Proper investigation and treatment, characterized by a long-term antibiotic therapy, play an important role on the outcome of the patient. The authors describe a case of a patient without neurological comorbidities who developed clinical signs of right occipital lobe impairment and seizures, whose investigation demonstrated brain abscess caused by Nocardia spp. The patient was treated surgically followed by antibiotic therapy with a great outcome after 1 year of follow-up.

Home intravenous antibiotic therapy

1993 ◽  
Vol 94 (1) ◽  
pp. 114 ◽  
Author(s):  
David T. Durack ◽  
A.W. Karchmer ◽  
Ralph Blair ◽  
auWalter Wilson ◽  
William Dismukes ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Intravenous Antibiotic ◽  
Intravenous Antibiotic Therapy

Management of complicated shunt infections: a clinical report

2008 ◽  
Vol 1 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Hector E. James ◽  
John S. Bradley
Keyword(s):  
Antibiotic Therapy ◽  
Treatment Protocol ◽  
Shunt Infection ◽  
The Body ◽  
Clinical Report ◽  
Intravenous Antibiotic ◽  
Once Daily ◽  
Intravenous Antibiotic Therapy ◽  
Shunt Infections

Object The authors present their experience with a protocol for the treatment of patients with complicated shunt infections. Methods Complicated shunt infections are defined for the purpose of this protocol as multiple compartment hydrocephalus, multiple organism shunt infection, severe peritonitis, or infections in other sites of the body. The initial treatment protocol for these patients was 3 weeks of intravenous antibiotic therapy and 2 weeks of twice daily intraventricular/intrashunt antibiotic therapy. Cerebrospinal fluid (CSF) cultures were monitored during therapy and obtained again 48 hours after completion. The shunt was completely replaced. Additionally, follow-up cultures were obtained in all patients 3–6 months after therapy was completed. Results A cure of the infection was achieved in all patients as defined by negative cultures obtained at completion of antibiotic therapy and in follow-up studies. The follow-up period was 2–11 years (mean 4.4 ± 2.5 years). The treatment protocol was modified in the patients treated after 1991, and 18 patients were treated with this modified treatment regime. In these patients, intraventricular antibiotics were administered only once daily for 14 days, and the CSF was cultured 24 hours after antibiotic therapy had been stopped instead of after 48 hours. The results were similar to those obtained with the initial protocol. Conclusions Based on their prospective nonrandomized series, the authors believe that patients with complicated shunt infections can be successfully treated with 2 weeks of intraventricular antibiotic therapy administered once daily, concurrent with 3 weeks of intravenous antibiotic therapy. This protocol reduces length of treatment and hospital stay, and avoids recurrence of infection.

MO1003ONSET OF BRAIN TOXOPLASMA GONDII ABSCESSES IN RENAL TRANSPLANT RECIPIENT IN THERAPY WITH BELATACEPT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Giuseppe Orefice ◽  
Raffaella Vigilante ◽  
Chiara Mennillo ◽  
Sofia Giuliana ◽  
Carolina Ruosi ◽  
...  
Keyword(s):  
Renal Function ◽  
Toxoplasma Gondii ◽  
Renal Transplant ◽  
Transplant Recipient ◽  
Serum Creatinine ◽  
Antibiotic Therapy ◽  
Brain Mri ◽  
Empiric Antibiotic Therapy ◽  
Short Period ◽  
Brain Abscesses

Abstract Background Belatacept is a new non-nephrotoxic anti-rejection drug that blocks the CD80 / CD86-CD28 complex, that normally activates T lymphocytes. Although the BENEFIT study proposes its use at the forefront of immunosuppressive therapy to prevent renal transplant rejection, the risk of opportunistic infections should not be underestimated, as demonstrated by the following clinical case. Case report We report the case of a 71-year-old male kidney transplant recipient that at 7-month follow-up showed a relevant rise of serum creatinine up to 3.8 mg/dl related to graft rejection. The patient started a cycle of treatment with Belatacept in accomplishment to international studies, with improvement in renal function (serum creatinine: 2.8 mg/dl). After 8 months of therapy, due to the appearance of left brachio-crural hypoasthenia, a brain CT and a brain MRI (both without contrast media because of the severe graft dysfunction) were consecutively performed. Imaging revealed multiple nodular formations in the right hemisphere, compatible with brain abscesses or neuro-lymphoma. Belatacept was promptly suspended, a rachicentesis for liquor analysis performed, and a broad spectrum empiric antibiotic therapy was started on Infectious Disease Specialist advice. After Toxoplasma Gondii positivity was found by PCR on cerebrospinal fluid, neuro-lymphoma was excluded and the patient was switched to a targeted antibiotic therapy with Trimethoprim / Sulfamethoxazole (dose adjusted to renal function) for 6 weeks and subsequently, a maintenance course with Sulfadiazine and Pyrimethamine. During treatment, brain lesions showed progressive reduction, with marked clinical improvement and stabilization of renal function (eGFR 25 ml / min). Conclusions As far as is known in the literature, this is the first case of Toxoplasma Gondii brain infection that can be correlated with the use of Belactacept. The appearance of a severe opportunistic infection, in a short period of time after the introduction of Belatacept, could indicate the direct role of Belatacept in the development of these brain abscesses and indicates the importance of carefully evaluating the use of the drug in elderly patients with reduced renal function, in which adequate prophylactic therapy would be particularly indicated.

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