Bacillus cereus brain abscesses occurring in a severely neutropenic patient: successful treatment with antimicrobial agents, granulocyte colony-stimulating factor and surgical drainage.
Multiple brain and liver abscesses developed immediately after Bacillus cereus bacteremia in a neutropenic patient with acute lymphoblastic leukemia. After even 8 weeks of antimicrobial chemotherapy together with administration of granulocyte colony-stimulating factor, every infectious process disappeared but the patient's headache has still persisted. Because the wall of one brain abscess became thin and was in danger of rupturing into the ventricle, surgical drainage was performed, resulting in disappearance of headache and resolution of brain abscess. The present case indicates that a combined medical and surgical approach is mandatory to treat patients with brain abscesses.
Sakai
C
C
Division of Hematology and Chemotherapy, Chiba Cancer Center Hospital.
Iuchi
T
T
Ishii
A
A
Kumagai
K
K
Takagi
T
T
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D001409:Bacillus cereus / Q000302:isolation & purification; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000628:therapy*; D004322:Drainage; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology* / Q000628:therapy*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007945:Leukemia, Lymphoid / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor