Multiple brain abscesses caused by Fusobacterium nucleatum treated conservatively.
BACKGROUND
Multiple brain abscesses are serious neurological problems with high mortality and disabling morbidity. The frequency is rising as a result of AIDS and the increasing number of immunocompromised patients.


METHODS
A 59-year-old woman developed signs and symptoms of diffuse brain dysfunction including fever and neck stiffness. A brain CT scan demonstrated nine contrast-enhancing ring-shaped lesions. Analysis of the cerebrospinal fluid using PCR-technique revealed DNA of Fusobacterium nucleatum. Conservative treatment with antibiotics was successful. The patient recovered with only mild cognitive deficits.


RESULTS
The experience of our patient and the review of the literature indicate that multiple brain abscesses due to Fusobacterium nucleatum are rare. The most probable source is oral infection.


CONCLUSIONS
Multiple brain abscesses may be caused by Fusobacterium nucleatum. Cerebrospinal fluid analysis using PCR technique is helpful with diagnosis. Conservative management can be successful.
Heckmann
Josef G
JG
Department of Neurology, University Hospital, Erlangen-Nuremberg, Germany.
Lang
Christoph J G
CJ
Hartl
Heinz
H
Tomandl
Bernd
B
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology*; D001929:Brain Edema / Q000188:drug therapy; D002443:Ceftriaxone / Q000627:therapeutic use; D003565:Cytidine Diphosphate / Q000031:analogs & derivatives / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005674:Fusobacterium Infections / Q000150:complications*; D016967:Fusobacterium nucleatum; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; C063721:fosfocytocin; D008795:Metronidazole; D003565:Cytidine Diphosphate; D002443:Ceftriaxone; D003907:Dexamethasone