title: Brain abscess in adult cirrhotic patients: two case reports.
abstract: Patients who have liver cirrhosis are at increased risk of bacterial infections, such as bacteremia, meningitis, pneumonia, urinary tract infections, and spontaneous bacterial peritonitis, due to immunodeficiency associated with the severity of the cirrhosis. Although bacterial infections are frequent in cirrhotic patients, only isolated cases of brain abscess have been reported. In these cirrhotic patients, the initial presentation of brain abscess may not be fever or leukocytosis, but focal neurologic deficits. In addition, for consideration of blood-brain barrier penetration, the anti-biotic choice postoperatively is also quite different from other infections outside the central nervous system. We will discuss two cases of brain abscess in cirrhotic patients with special emphasis on the clinical presentation, magnetic resonance spectroscopic findings, organism encountered, therapeutic strategy, and prognosis.
authors.affiliation: Department of Neurosurgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chia-Li
authors.initials: CL
authors.lastname: Chung
authors.forename: Ann-Shung
authors.initials: AS
authors.lastname: Lieu
authors.forename: I-Yi
authors.initials: IY
authors.lastname: Chen
authors.forename: Aij-Lie
authors.initials: AL
authors.lastname: Kwan
authors.forename: Shen-Long
authors.initials: SL
authors.lastname: Howng
mesh_terms: D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D001922:Brain Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002794:Choline / Q000032:analysis; D003401:Creatine / Q000032:analysis; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline