title: Brain abscess developing in a non-operated spontaneous intracerebral haemorrhage: a case report and literature review.
abstract: Brain abscesses are a rare but potentially lethal neurological lesions, generally occurring after septic episodes in immunodeficient patients or complicating neurosurgical procedures. Even though they are known complications of surgically treated intracerebral haemorrhages (ICH), the presence of a brain abscess at the site of an untreated ICH is a rare event. Such cases may result from haematogenous spread from distant foci or contiguous sites and are often preceded by episodes of sepsis and local infection. Immunodeficiency, AIDS, age, diabetes mellitus and vitamin-K deficiency are predisposing factors. Abscess formation should be considered in case of clinical deterioration, headache, and any neurological deficit after febrile episodes. Early diagnosis with neuroradiological imaging, infection blood markers and microbiological identification of the causative pathogen is crucial for treatment with surgical drainage or excision and specific antibiotic therapy, which guarantee good outcome and long-term survival. In fact, while prompt diagnosis and treatment guarantee good outcome and long-term survival, morbidity and mortality are very high in case of misdiagnosis. We report a case of a 49-year old man presenting with a brain abscess 13 weeks after a spontaneous ICH, without previous episodes of sepsis and with a suspected septic arthritis 2 weeks after abscess drainage.
authors: Catholic University, Faculty of Medicine, Department of Neurosurgery, Rome, Italy.
authors: Luigi
authors: L
authors: Rigante
authors: Tommaso
authors: T
authors: Tufo
authors: Giancarlo
authors: G
authors: Scoppettuolo
authors: Concetta
authors: C
authors: Donato
authors: Annunziato
authors: A
authors: Mangiola
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000209:etiology* / Q000382:microbiology / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000150:complications*; D059248:Chemoradiotherapy; D004322:Drainage; D004401:Dysarthria / Q000209:etiology; D006261:Headache / Q000209:etiology; D006689:Hodgkin Disease / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D064704:Levofloxacin / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D010068:Oxacillin / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D013131:Spine / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D010068:Oxacillin; D012293:Rifampin