Pyogenic brain abscess caused by Serratia marcescens in a Brazilian premature neonate

Bacterial brain abscess remain a serious central nervous system infectious disorder despite advances in neurosurgical, neuroimaging, clinical support on intensive care units, microbiological techniques and availability of new antibiotics. The successful treatment of brain abscess usually requires surgery, appropriate antibiotic therapy and eradication of the primary source. Although uncommon, brain abscesses are particularly important in the pediatric population due to its devastating potential to cause severe neurologic deficits, especially in preterm newborns. The purpose of the present report is to describe the case of a Brazilian premature neonate with pyogenic brain abscesses caused by Serratia marcescens and to discuss therapeutic and diagnostic approaches. The early suspicion, proper diagnostic measures and immediate neurosurgical consultation associated with aggressive antibiotic therapy seem to be the essentials steps on themanagement for those high-risk pediatric patients.

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Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses

Surgical Neurology International ◽

10.25259/sni_20_2020 ◽

2020 ◽

Vol 11 ◽

pp. 140

Author(s):

Ruth Prieto ◽

Alejandro Callejas-Díaz ◽

Rasha Hassan ◽

Alberto Pérez de Vargas ◽

Luis Fernando López-Pájaro

Keyword(s):

Antibiotic Therapy ◽

Brain Abscess ◽

Primary Source ◽

16S Rrna Gene Sequencing ◽

Rrna Gene ◽

Sequencing Analysis ◽

Surgical Drainage ◽

Source Of Infection ◽

Parvimonas Micra ◽

Brain Abscesses

Background: Brain abscess is a life-threatening entity which requires prompt and long-term antibiotic therapy, generally associated with surgical drainage, and eradicating the primary source of infection. Parvimonas micra (Pm) has only been reported once before as the lone infecting organism of an orally originated, solitary brain abscess. Diagnosing brain abscesses caused by this Gram-positive anaerobic coccus, constituent of the oral cavity flora, is challenging, and an optimal treatment regimen has not been well established. We report the diagnosis and successful treatment of a Pm caused odontogenic brain abscess. Case Description: A 62-year-old immunocompetent male with a right-parietal brain abscess presented with headache and seizures. He was started on empirical antibiotic therapy and subsequently underwent surgical drainage. The only source of infection found was severe periodontitis with infected mandibular cysts. Thus, tooth extraction and cyst curettage were performed 1 week after brain surgery. Cultures of brain abscess fluid were negative, but amplification of bacterial 16S ribosomal RNA (rRNA) with polymerase chain reaction demonstrated Pm. After 3 weeks of intravenous ceftriaxone and metronidazole, the patient was switched to oral metronidazole and moxifloxacin for 6 weeks. Conclusions: This case highlights the potential risk of untreated dental infections causing brain abscesses. Pm should be considered as a possible pathogen of odontogenic brain abscesses despite its presence usually not being detected by standard bacterial cultures. Therefore, 16S rRNA gene sequencing analysis is strongly recommended for bacterial identification before defining brain abscesses as cryptogenic.

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Successfully treated multiple brain abscess in a newborn: a case report

Romanian Neurosurgery ◽

10.1515/romneu-2017-0026 ◽

2017 ◽

Vol 31 (2) ◽

pp. 172-177

Author(s):

Aleksic Vuk ◽

Mihajlovic Miljan ◽

Zivković Nenad ◽

Misela Raus ◽

Marko Samardzic ◽

...

Keyword(s):

Case Report ◽

Antibiotic Therapy ◽

Brain Abscess ◽

Ventriculoperitoneal Shunt ◽

Combined Therapy ◽

Late Complication ◽

Primary Source ◽

Medical Problem ◽

High Morbidity ◽

Brain Abscesses

Abstract Multiple brain abscesses are exceedingly uncommon in newborns and represent a serious medical problem associated with high morbidity and mortality. Treatment is also controversial issue, and can require surgery, abscess aspiration, antibiotic therapy, and eradication of the primary source. We report a case of successfully treated multiple brain abscess in a newborn with combined therapy which consisted of abscess aspiration and prolonged antibiotics. Patient developed hydrocephalus as late complication which was also successfully treated with ventriculoperitoneal shunt.

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Brain Abscess Caused by Nocardia: Case Report and Literature Review

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0040-1719124 ◽

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.

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Management of Intracranial Abscess - Study of 30 cases

TAJ Journal of Teachers Association ◽

10.3329/taj.v16i2.3887 ◽

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

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Brain Abscess in the Current Decade (2010–2019) in India—A Review

Indian Journal of Neurosurgery ◽

10.1055/s-0041-1725230 ◽

2021 ◽

Author(s):

R. Ravikumar ◽

Daisy Vanitha John

Keyword(s):

Brain Abscess ◽

Multidisciplinary Treatment ◽

Treatment Strategies ◽

Primary Source ◽

Neurosurgical Procedures ◽

Suppurative Otitis Media ◽

Patients Âgés ◽

Source Of Infection ◽

Middle Ear Infection ◽

Microbiological Techniques

AbstractBrain abscess outcomes have improved in recent years due to advancements in cranial imaging, microbiological techniques, minimally invasive neurosurgical procedures, and effective antibiotic treatments. However, the incidence of brain abscess remains unchanged in developing countries. We searched PubMed and Google Scholar for references using the key words “brain abscess” and “India” and reviewed both retrospective and prospective studies published in peer-reviewed journals in the current decade to understand the present status. The review shows that the patients’ ages, the predominance of male patients, the symptoms and locations of brain abscesses, and the types of bacteria associated with them have remained unchanged over the past decade. The most common predisposing condition in recent years has been chronic suppurative otitis media with a mortality rate of 7 to 10%. Middle ear infection is often neglected and not treated aggressively in Asian countries. It requires multidisciplinary treatment strategies to address the primary source of infection and better health awareness to prevent the development of brain abscess.

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Cerebral abscess caused by Serratia marcescens in a premature neonate

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2007000600021 ◽

2007 ◽

Vol 65 (4a) ◽

pp. 1018-1021 ◽

Cited By ~ 11

Author(s):

Tatiana Mattos Hirooka ◽

Ricardo Braganca de Vasconcellos Fontes ◽

Edna Maria Diniz ◽

Fernando Campos Pinto ◽

Hamilton Matushita

Keyword(s):

Serratia Marcescens ◽

Distress Syndrome ◽

Clinical Signs ◽

Rare Condition ◽

Premature Neonate ◽

Cerebral Abscess ◽

High Dose ◽

Diagnostic Measures ◽

Therapeutic Measures ◽

Male Neonate

BACKGROUND: Cerebral abscesses are extremely rare in neonates. Serratia marcescens is an unusual cause of sepsis and neurological spread is especially ominous. PURPOSE: To report the case of a 34-week neonate who developed this rare condition and to discuss diagnostic and therapeutic measures. CASE REPRT: A 34-week male neonate sequentially developed respiratory distress syndrome, early sepsis and necrotizing enterocolitis; later cultures revealed S. marcescens. After deterioration, a cerebral abscess became evident, which revealed S. marcescens. Clinical improvement ensued after high-dose amikacin and meropenem. CONCLUSION: Clinical signs are often non-specific. Proper diagnostic measures, neurosurgical consultation and aggressive antibiotic therapy are essential for these high-risk neonates.

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Haemophilus paraphrophilus brain abscess in a 9-year-old boy: Case report and literature review

International Journal of Applied Biology ◽

10.20956/ijab.v4i1.9187 ◽

2020 ◽

Vol 4 (1) ◽

pp. 21-26

Author(s):

Hind ZRIKEM ◽

Loubna AIT SAID ◽

Kawtar ZAHLANE

Keyword(s):

Case Report ◽

Brain Abscess ◽

Pediatric Population ◽

Positive Culture ◽

Left Hemiparesis ◽

Blurred Vision ◽

Gram Negative ◽

Chocolate Agar ◽

Gram Staining ◽

Brain Abscesses

Human diseases due to A. paraphrophilus aren’t usual. The following case report describes the first isolated case of A. paraphrophilus brain abscess in our laboratory. A 9-year-old boy presented to pediatric emergencies for frontal headache, vomiting, blurred vision and left hemiparesis. Radiological diagnosis consists with a frontal abscess. Gram staining of purulent samples showed abundant neutrophils with gram negative bacilli. Culture was made on blood agar, chocolate agar, Chapman’s agar and incubated in 5% CO2 at 37°C for 24 hours. Positive culture was detected only on chocolate agar. It was monomicrobial with small yellowish non-hemolytic colonies. Gram stain of colonies showed pleomorphic gram-negative coccobacilli. The strain required V factor for growth. The isolated strain was sensitive to all antibiotics tested. The interest of this case is that it shows the emergence of A. paraphrophilus as a causative agent of brain abscesses on pediatric population without associated congenital heart disease. It may also help identifying risk factors of these infections and how to prevent them.

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

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab111.0027 ◽

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

Case Reports in Infectious Diseases ◽

10.1155/2018/6549496 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 1

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.

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