1/32. Fungus-like hyphochytrids associated with human disease.We report two cases, with liver and brain abscess, respectively, where fungus-like organisms belonging to the Hyphochytriomycota were found at the site of inflammation together with peptococcus in the first and cysticercus cellulosae in the second case. This is the first time these groups of organisms have been reported in human material. The role of hyphochytrids in human pathology remained uncertain as they were found together with already known human pathogens.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/32. Unusual complication--VP shunt coming out per rectum and brain abscess.VP shunt is the most common pediatric neurosurgical procedure. It has been shown to result in variety of complications, which may have devastating consequences. Discussed below is one of the rare complications and the strategy to manage it successfully.- - - - - - - - - - ranking = 4keywords = brain (Clic here for more details about this article) |
3/32. Treatment of a vancomycin-resistant enterococcus faecium ventricular drain infection with quinupristin/dalfopristin and review of the literature.central nervous system infections involving vancomycin-resistant enterococcus faecium (VREF) are infrequently described and pose significant therapeutic difficulties, because these organisms are intrinsically resistant to many antibiotics. We describe the use of intrathecal quinupristin/dalfopristin to treat a VREF-associated infection in a neuro--surgical patient.- - - - - - - - - - ranking = 0.40731968302653keywords = nervous system (Clic here for more details about this article) |
4/32. Infection of central nervous system by motile Enterococcus: first case report.A 66-year-old man with four indwelling ventriculoperitoneal shunts for multiloculated hydrocephalus from a complicated case of meningitis a year before developed shunt infection based on a syndrome of fever, drowsiness, and cerebrospinal fluid neutrophil pleocytosis in the background of repeated surgical manipulation to relieve successive shunt blockages. The cerebrospinal fluid culture, which yielded a motile Enterococcus species, was believed to originate from the gut. This isolate was lost in storage and could not be characterized further. The patient improved with vancomycin and high-dose ampicillin therapy. He relapsed a month later with Enterococcus gallinarum shunt infection, which responded to high-dose ampicillin and gentamicin therapy. This is probably the first case report of motile Enterococcus infection of the central nervous system.- - - - - - - - - - ranking = 9.3058436186686keywords = central nervous system, nervous system (Clic here for more details about this article) |
5/32. 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.- - - - - - - - - - ranking = 8keywords = brain (Clic here for more details about this article) |
6/32. Focal intracranial infections due to propionibacterium acnes: report of three cases.OBJECTIVE AND IMPORTANCE: Except for its role in shunt infections, propionibacterium acnes has been of little interest to neurosurgeons. The rarity and indolent nature of focal intracranial infections by P. acnes limit their recognition. Three cases of serious intracranial infection due to this organism are described. CLINCAL PRESENTATION: Three patients with histories of immunosuppression and neurosurgical procedures developed nonspecific, delayed presentations (5 wk to 5 yr after surgery) of intracranial infections. In two patients, radiological investigations showed enhancing lesions that were later found to be brain abscesses. A subdural empyema was found in the third patient. INTERVENTION: All three patients underwent surgical drainage of the purulent collections. P. acnes was isolated in each case, and each patient was treated with a 6-week course of intravenous penicillin. All three patients made good recoveries, and subsequent imaging showed no recurrence of the infectious collections. CONCLUSION: P. acnes is an indolent organism that may rarely cause severe intracranial infections. This organism should be suspected when an intracranial purulent collection is discovered in a patient with a history of neurosurgical procedures. Immunosuppressed patients may be susceptible to this otherwise benign organism. Surgical drainage and treatment with intravenous penicillin should be considered standard therapy.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
7/32. Cerebral Whipple's disease with a stroke-like presentation and cerebrovascular pathology.Although neurological symptoms are common in Whipple's disease, patients rarely have a purely neurological presentation and involvement restricted to the central nervous system is uncommon. A 39 year old woman presented with a meningoencephalitic illness, which responded to penicillin. Eleven months later she developed recurrent stroke-like episodes. Patchy enhancing meningeal, cortical, and subcortical lesions thought to be vascular in origin developed within nine days of the onset of symptoms. No evidence was found of a cardiovascular source of emboli, vasculitis, or thrombophilic condition. A brain biopsy showed meningoencephalitic features suspicious of Whipple's disease associated with leptomeningeal arterial fibrosis and thrombosis. dna polymerase chain reaction confirmed tropheryma whippelii in both blood and brain tissue. The neurological manifestations of cerebral Whipple's disease are varied and very rarely include stroke-like symptoms. The pathogenesis of cerebral infarction in Whipple's disease is not well established but arterial fibrosis and endocarditis complicated by embolisation have been reported. This case emphasises the importance of early brain biopsy in unusual cases of stroke and illustrates the clinical utility of polymerase chain reaction to confirm Whipple's disease.- - - - - - - - - - ranking = 4.8611687237337keywords = central nervous system, brain, nervous system (Clic here for more details about this article) |
8/32. Metastatic intracranial abscesses of bronchopulmonary origin.Intracranialabscesses are serious, life-threatening infections despite recent advances in diagnosis and treatment. We report the case of a child with metastatic brain abscesses and a chronic, sharp foreign body of the bronchus. Its presentation and endoscopic appearance and the microbiology of the abscesses are detailed. The detection of bacteria of respiratory origin should lead to a search for a bronchopulmonary source of contamination.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
9/32. Treatment of central nervous system infection by vancomycin-resistant enterococcus faecium.Enterococci are uncommon causes of CNS infection. We describe a case of ventriculitis and Ommaya reservoir infection due to vancomycin-resistant enterococcus faecium successfully treated with the combination of i.v. quinupristin/dalfopristin and i.v. linezolid. The patient deteriorated after receiving three dosages of intraventricular quinupristin/dalfopristin. He recovered after discontinuation of intraventricular quinupristin/dalfopristin.- - - - - - - - - - ranking = 7.4446748949349keywords = central nervous system, nervous system (Clic here for more details about this article) |
10/32. Fusobacterial brain abscess: a review of five cases and an analysis of possible pathogenesis.OBJECT: The cases of five patients with fusobacterial brain abscess are presented. The authors discuss their attempt to determine the pathogenesis. methods: The clinical and microbiological features of five cases of fusobacterial brain abscess are reviewed. Isolates of 2031 Fusobacterium spp. and other anaerobes collected (1989-2002) at our institution were analyzed and compared for incidences and isolation sources. The findings were correlated with extensive literature on the subject. The five patients were men between 45 and 74 years of age. All experienced an insidious onset of the disease and probable hematogenous seeding of the organism(s). One patient had a monomicrobic fusobacterium necrophorum abscess, whereas the others had polymicrobic F. nucleatum abscesses. Despite surgery and a regimen of antibiotic medications and dexamethasone, three patients experienced a paradoxical deterioration 3 days postoperatively that necessitated reevacuation of the lesion. The evacuants observed at that time contained numerous leukocytes but no microorganisms, suggesting intensified inflammation as the likely cause of deterioration. This explanation is supported by literature that fusobacteria strongly activate neutrophils. An analysis of the 2031 anaerobes from blood, wounds, and abscesses showed the considerable virulence of Fusobacterium spp., which were able to enter and/or sustain themselves in the blood circulation. This pattern was similar to that of clostridium spp., but different from those of peptostreptococcus spp., bacteroides spp., and prevotella spp., which were less invasive but more abundant. CONCLUSIONS: Some fusobacterial brain abscesses may be associated with a paradoxical postoperative deterioration, which is probably due to intensified inflammation following treatment. The blood-borne dissemination and invasive behavior of fusobacteria likely initiate such a brain abscess, and further seeding of other synergic bacteria leads to a polymicrobic abscess.- - - - - - - - - - ranking = 8keywords = brain (Clic here for more details about this article) |
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