Systemic antibiotic therapy on multiple intracerebral abscesses of unknown origin.
A 68-year old patient presented with increasing right-sided weakness, dysarthria, pyrexia and a deteriorating general condition. CT and MRI showed about 20 round hyperdense lesions with peripheral enhancement of contrast material up to 1.5 cm in diameter. Antibiotic triple-therapy using ceftriaxone, gentamycin and metronidazole for 39 days and followed by antibiotic double-therapy using ceftriaxone and metronidazole for a further 22 days resulted in a radiologically proven reduction of the abscesses to very small remnants which disappeared completely during the follow-up period of two years. Simultaneously the general condition of the patient improved significantly. Repeated attempts at isolation of bacteria, fungi, protozoa and parasites from a subdural empyema failed. The histological examination of an abscess, which was entirely removed on occipital craniotomy, showed a structure resembling actinomycosis.
Sommer
F
F
Behandlungszentrum Vogtareuth, Department of Neurosurgery, Germany.
Aldini
R
R
Kolodziejczyk
D
D
D000196:Actinomycosis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D000368:Aged; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D002443:Ceftriaxone / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005839:Gentamicins; D008795:Metronidazole; D002443:Ceftriaxone