scholarly journals Potential Nosocomial Acquisition of EpidemicListeria monocytogenesPresenting as Multiple Brain Abscesses Resembling Nocardiosis

2010 ◽  
Vol 21 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Aleksandra Stefanovic ◽  
James Reid ◽  
A Celine Nadon ◽  
Jennifer Grant
Keyword(s):  
Listeria Monocytogenes ◽  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Hematological Malignancies ◽  
Solid Organ ◽  
Gram Stain ◽  
Current Case ◽  
Cerebellar Abscess ◽  
Immunosuppressed Patients ◽  
Brain Abscesses

Listerial brain abscesses are rare, and are found mostly in patients with underlying hematological malignancies or solid-organ transplants. A case of a patient with Crohn’s disease and multiple brain abscesses involving the left cerebellum and right sylvian fissure is described. The Gram stain and histopathology of the cerebellar abscess revealed Gram-positive, beaded rods suggestive ofNocardia. However, on culture,Listeria monocytogeneswas identified.Listeriamay appear Gram-variable and has been misidentified as streptococci, enterococci and diphtheroids. The present case is the first reported case ofL monocytogenesresemblingNocardiaon both microbiological and histopathological assessment. Reported cases of listerial brain abscesses are sporadic, while the current case was part of a nationwide listerial outbreak linked to consumption of contaminated deli meats. Broad antimicrobial therapy (including antilisterial coverage) in immunosuppressed patients presenting with brain abscess is crucial, until cultures confirm the identification of the organism.

scholarly journals Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment—Two Cases and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Beatrice Tiri ◽  
Giulia Priante ◽  
Lavinia Maria Saraca ◽  
Lucia Assunta Martella ◽  
Stefano Cappanera ◽  
...  
Keyword(s):  
Listeria Monocytogenes ◽  
Literature Review ◽  
Brain Abscess ◽  
Medical Therapy ◽  
Opportunistic Pathogen ◽  
Mortality Rates ◽  
Controversial Issues ◽  
Biopsy Material ◽  
Brain Abscesses ◽  
System Manifestation

Listeria monocytogenes (LM) is an opportunistic pathogen, and the most common central nervous system manifestation is meningitis while listerial brain abscesses are rare. We describe 2 cases of brain abscess due to LM and a literature review. Only 73 cases were reported in the literature from 1968 to 2017. The mean age was 51.9, and the mortality rate was 27.3%. In 19% of cases, no risk factors for neurolisteriosis were identified. Blood cultures were positive in 79.5% while CSF or brain abscess biopsy material was positive in 50.8%. In 40% was started a monotherapy regimen while in 60% a combination therapy without substantial differences in mortality. Fifty-two percent underwent neurosurgery while 45.3% has been treated only with medical therapy. The mortality rates were, respectively, 13% and 38.2%. Only 25% of patients who were treated for ≤6 weeks underwent neurosurgery, while 80% of those who were treated for ≥8 weeks were operated. The mortality rates were, respectively, 12.5% and 0%, suggesting that a combined approach of surgery and prolonged medical therapy would have an impact on mortality. We believe that it is essential to carry out this review as brain abscesses are rare, and there are no definitive indications on the optimal management, type, and duration of therapy.

Cerebral Abscess Caused by Listeria monocytogenes: Case Report and Literature Review

2021 ◽  
Author(s):  
Debora Cipriani ◽  
Michael Trippel ◽  
Klaus-Jürgen Buttler ◽  
Eva Rohr ◽  
Dirk Wagner ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Listeria Monocytogenes ◽  
Review Of The Literature ◽  
Case Presentation ◽  
Stereotactic Aspiration ◽  
Invasive Diseases ◽  
Immunosuppressed Patients ◽  
The Central Nervous System ◽  
Brain Abscesses

Abstract Background Listeria monocytogenes is an opportunistic gram-positive, facultative intracellular bacterium that causes invasive diseases mostly in pregnant women and immunosuppressed patients. Despite the predilection toward the central nervous system (CNS), it usually causes meningitis and meningoencephalitis, whereas brain abscesses are very uncommon. Case presentation We describe the case of a 69-year-old homeless patient with a brain abscess due to L. monocytogenes who was successfully treated surgically by a guided stereotactic aspiration and antibiotic therapy with ampicillin and gentamicin. Our patient was discharged after 4 weeks of therapy without neurologic deficits. Additionally, we provide a review of the literature of brain abscesses caused by L. monocytogenes. Conclusions This case highlights the need to drain cerebral abscesses and culture pus to correctly treat patients with antibiotics, especially given the high mortality rate of this infectious entity.

scholarly journals Brain Abscess Associated with Polymicrobial Infection after Intraoral Laceration: A Pediatric Case Report

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fumihiro Ochi ◽  
Hisamichi Tauchi ◽  
Toyohisa Miyata ◽  
Tomozo Moritani ◽  
Toshiyuki Chisaka ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Fusobacterium Nucleatum ◽  
Brain Parenchyma ◽  
Pediatric Case ◽  
Parvimonas Micra ◽  
Increased Risk ◽  
Brain Abscesses ◽  
Congenital Cyanotic Heart Disease ◽  
The Brain

Brain abscesses, infections within the brain parenchyma, can arise as complications of various conditions including infections, trauma, and surgery. However, brain abscesses due to polymicrobial organisms have rarely been reported in children. We herein report a case of a 9-year-old girl with unresolved congenital cyanotic heart disease (CCHD) presenting with right hemiplegia who was diagnosed with brain abscess caused by Streptococcus intermedius, Parvimonas micra, and Fusobacterium nucleatum after oropharyngeal injury. She was treated with intravenous antimicrobial therapy, drainage under craniotomy, and antiedema therapy with glycerol and goreisan, which led to the improvement of right hemiplegia to baseline; she was discharged following eight weeks of intravenous antimicrobial therapy. The clinical diagnosis of the brain abscess was difficult due to the nonspecific presentation, highlighting the importance of cranial imaging without haste in patients at increased risk for brain abscesses such as those with CCHD, presenting with fever in the absence of localizing symptoms or fever, accompanied with abnormal neurological findings.

scholarly journals Listeria monocytogenes Brain Abscess Mimicking Ischemic Stroke in an Immunocompromised Patient: A Case Report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Angeliki Tsifi ◽  
Stavroula Panagiota Lontou ◽  
Maria Triantafyllou ◽  
Sevastianos Chatzidavid ◽  
Dimitrios Theodoridis ◽  
...  
Keyword(s):  
Listeria Monocytogenes ◽  
Brain Abscess ◽  
Corticosteroid Treatment ◽  
Antimicrobial Treatment ◽  
Oral Amoxicillin ◽  
Brain Abscesses ◽  
Recent Diagnosis ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Study

Listeria monocytogenes (L. monocytogenes) is a Gram-positive bacillus that infects immunocompromised persons, neonates, pregnant women and, occasionally, previously healthy individuals. L. monocytogenes brain abscesses are particularly rare.We present a 62-year-old female on corticosteroid treatment due to a recent diagnosis of autoimmune hepatitis, who suddenly developed right hemiparesis mimicking a stroke. A brain computerized tomography (CT) scan revealed a brain abscess and the blood cultures drawn yielded L. monocytogenes. A conservative treatment without surgical intervention was selected. The patient was commenced on intravenous ampicillin and gentamicin and showed remarkable improvement. She was successfully discharged on oral amoxicillin with probenecid. Since the subsequent magnetic resonance imaging (MRI) study and CT scans exhibited reduction in the size of the abscess, the antimicrobial treatment was discontinued after a three-month period. The patient underwent regular follow-up visits with no signs of relapse.

Management of brain abscess: an overview

2008 ◽  
Vol 24 (6) ◽  
pp. E3 ◽  
Author(s):  
Ranjith K. Moorthy ◽  
Vedantam Rajshekhar
Keyword(s):  
Computed Tomography ◽  
Heart Disease ◽  
Brain Abscess ◽  
Marked Decrease ◽  
Empirical Therapy ◽  
Cyanotic Heart Disease ◽  
Stereotactic Techniques ◽  
Formidable Challenge ◽  
Immunosuppressed Patients ◽  
Brain Abscesses

✓ Recent advances in neuroimaging have resulted in a marked decrease in morbidity and death due to brain abscesses. The advent of computed tomography–guided stereotaxy has reduced morbidity in patients with deep-seated abscesses. Empirical therapy is best avoided in the present era, particularly given the availability of stereotactic techniques for aspiration and confirmation of diagnosis. Despite these advances, management of abscesses in patients with cyanotic heart disease and in immunosuppressed patients remains a formidable challenge. Unusual as well as more recently recognized pathogens are being isolated from abscesses in immunosuppressed patients. The authors provide an overview of the management of brain abscesses, highlighting their experience in managing these lesions in patients with cyanotic heart disease, stereotactic management of brain abscesses, and management of abscesses in immunosuppressed patients.

scholarly journals Cerebral Abscess Potentially of Odontogenic Origin

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Marouene Ben Hadj Hassine ◽  
Lamia Oualha ◽  
Amine Derbel ◽  
Nabiha Douki
Keyword(s):  
Brain Abscess ◽  
Odontogenic Infection ◽  
Successful Outcome ◽  
Antibiotic Regimen ◽  
Abscess Drainage ◽  
Microscopic Identification ◽  
Relative Paucity ◽  
Cerebellar Abscess ◽  
Odontogenic Origin ◽  
Brain Abscesses

Odontogenic origins are rarely implicated in the formation of brain abscesses. The relative paucity of this kind of infection and the difficulty in matching the causative microorganisms of a brain abscess to an odontogenic source can explain the late management of patients. We herein describe a case of a 46-year-old man with a cerebellar abscess that was probably due to an odontogenic infection. The diagnosis supported by imaging and microscopic identification, mini craniectomy for abscess drainage followed by eradication of all potential dental infectious foci, and an antibiotic regimen based on cephalosporins, metronidazole, and vancomycine contributed to a successful outcome.

scholarly journals Cancer immunotherapy in special challenging populations: recommendations of the Advisory Committee of Spanish Melanoma Group (GEM)

2021 ◽  
Vol 9 (3) ◽  
pp. e001664
Author(s):  
Maria Gonzalez-Cao ◽  
Teresa Puertolas ◽  
Mar Riveiro ◽  
Eva Muñoz-Couselo ◽  
Carolina Ortiz ◽  
...  
Keyword(s):  
Cancer Immunotherapy ◽  
Multidisciplinary Approach ◽  
Checkpoint Inhibitors ◽  
Solid Organ Transplantation ◽  
Latent Tuberculosis ◽  
Solid Organ ◽  
Chronic Infections ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Evidence Based Guidelines

Cancer immunotherapy based on the use of antibodies targeting the so-called checkpoint inhibitors, such as programmed cell death-1 receptor, its ligand, or CTLA-4, has shown durable clinical benefit and survival improvement in melanoma and other tumors. However, there are some special situations that could be a challenge for clinical management. Persons with chronic infections, such as HIV-1 or viral hepatitis, latent tuberculosis, or a history of solid organ transplantation, could be candidates for cancer immunotherapy, but their management requires a multidisciplinary approach. The Spanish Melanoma Group (GEM) panel in collaboration with experts in virology and immunology from different centers in Spain reviewed the literature and developed evidence-based guidelines for cancer immunotherapy management in patients with chronic infections and immunosuppression. These are the first clinical guidelines for cancer immunotherapy treatment in special challenging populations. Cancer immunotherapy in chronically infected or immunosuppressed patients is feasible but needs a multidisciplinary approach in order to decrease the risk of complications related to the coexistent comorbidities.

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.

scholarly journals Risk of infection associated with targeted therapies for solid organ and hematological malignancies

2021 ◽  
Vol 8 ◽  
pp. 204993612198954
Author(s):  
Isabel Ruiz-Camps ◽  
Juan Aguilar-Company
Keyword(s):  
Hematological Malignancies ◽  
Opportunistic Infections ◽  
Respiratory Infections ◽  
Fungal Infections ◽  
Checkpoint Inhibitors ◽  
Janus Kinase ◽  
Prolonged Treatment ◽  
Solid Organ ◽  
Risk Of Infection ◽  
Increased Risk

Higher risks of infection are associated with some targeted drugs used to treat solid organ and hematological malignancies, and an individual patient’s risk of infection is strongly influenced by underlying diseases and concomitant or prior treatments. This review focuses on risk levels and specific suggestions for management, analyzing groups of agents associated with a significant effect on the risk of infection. Due to limited clinical experience and ongoing advances in these therapies, recommendations may be revised in the near future. Bruton tyrosine kinase (BTK) inhibitors are associated with a higher rate of infections, including invasive fungal infection, especially in the first months of treatment and in patients with advanced, pretreated disease. Phosphatidylinositol 3-kinase (PI3K) inhibitors are associated with an increased risk of Pneumocystis pneumonia and cytomegalovirus (CMV) reactivation. Venetoclax is associated with cytopenias, respiratory infections, and fever and neutropenia. Janus kinase (JAK) inhibitors may predispose patients to opportunistic and fungal infections; need for prophylaxis should be assessed on an individual basis. Mammalian target of rapamycin (mTOR) inhibitors have been linked to a higher risk of general and opportunistic infections. Breakpoint cluster region-Abelson (BCR-ABL) inhibitors are associated with neutropenia, especially over the first months of treatment. Anti-CD20 agents may cause defects in the adaptative immune response, hypogammaglobulinemia, neutropenia, and hepatitis B reactivation. Alemtuzumab is associated with profound and long-lasting immunosuppression; screening is recommended for latent infections and prevention strategies against CMV, herpesvirus, and Pneumocystis infections. Checkpoint inhibitors (CIs) may cause immune-related adverse events for which prolonged treatment with corticosteroids is needed: prophylaxis against Pneumocystis is recommended.

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