1/107. brain abscess caused by streptococcus intermedius: two case reports.BACKGROUND: Although streptococcus intermedius has been recognized as an important pathogen for abscess formation outside the central nervous system, the streptococcus milleri group, of which it is a member, has not been recognized as a specific pathogen for brain abscess, often thought to be caused by Streptococcus viridans, which includes other streptococcal species. CASE DESCRIPTION: Two cases of brain abscess in the left frontal lobe caused by S. intermedius, which responded well to antimicrobial treatment combined with needle aspiration, are presented. In the first patient, the predisposing disease was paranasal sinusitis of the frontal and ethmoid sinuses. In the second patient, the source of the pathogen was not detected despite extensive examination. The patients underwent aspiration of pus under ultrasound guidance in the first patient, and via a computed tomography-guided stereotactic procedure in the second patient. They subsequently received appropriate antimicrobial therapy against S. intermedius isolated from the pus culture. Both patients were discharged without any neurological deficits. CONCLUSION: It is important to recognize S. intermedius as a pathogen of brain abscess, and to be aware of its predisposing factors, i.e., mucosal disturbance and liver abscess.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/107. Palinopsia with bacterial brain abscess and noonan syndrome.Though positive visual symptoms can be psychological in nature, or can result from a perceptive or anxious patients recognizing optical principals in the eye itself, this case illustrates how a thorough history is required to delineate those rarer signs which accompany serious macular or neuro-ophthalmic pathology.- - - - - - - - - - ranking = 1.3333333333333keywords = brain (Clic here for more details about this article) |
3/107. Group A streptococcal brain abscess.A 48-y-old woman with an acute Group A streptococcal brain abscess is described. The abscess enlarged rapidly with neurological deterioration and required open drainage and excision. The patient was treated with antibiotics for 6 weeks and recovered completely. Group A streptococcus is a rare cause of brain abscess in the antibiotic era and may require urgent neurosurgical intervention.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
4/107. Acute onset of chorea and dystonia following a febrile illness in a 1-year-old boy.A 12-month-old boy with acute onset hemichorea and dystonia following a gastroenteritis has abnormal signal intensities of his basal ganglia on brain magnetic resonance imaging (MRI). A rigorous laboratory investigation is successful in diagnosing his rare condition. A discussion of the differential of abnormal basal ganglia on MRI is presented to help illustrate this case.- - - - - - - - - - ranking = 0.33333333333333keywords = brain (Clic here for more details about this article) |
5/107. Successful treatment of brainstem abscess with stereotactic aspiration.BACKGROUND: Brainstem abscess is an uncommon condition associated with a high mortality. We report a case of brainstem abscess in a 51-year-old female with a pulmonary arteriovenous fistula that was cured after appropriate antibiotic therapy following stereotactic aspiration. The value of stereotactic aspiration in the management of brainstem abscess is documented with a review of the relevant literature. CASE REPORT: A 51-year-old female with a pulmonary arteriovenous fistula suffered fever, diplopia and weakness on the right side. Magnetic resonance (MR) imaging of the brain showed a large cystic mass with ring-like enhancement in the brainstem. A diagnosis of brainstem abscess as a complication of pulmonary arteriovenous fistula was made. MR imaging-guided stereotactic exploration was carried out via the suboccipital transcerebellar approach and the pathogen of the brainstem abscess was identified. The brainstem abscess was cured after treatment employing antibiotics to which the pathogen was sensitive. CONCLUSIONS: Stereotactic aspiration is an effective procedure for brainstem abscesses. This procedure is less invasive than open surgery and can be performed even in patients in poor general condition.- - - - - - - - - - ranking = 4keywords = brain (Clic here for more details about this article) |
6/107. Brain abscesses from neglected open head injuries: experience with 17 cases over 20 years.We are reviewing our experience with 17 civilian cases with post-traumatic brain abscesses treated in the era of CT scanning over a period of 20 years. The principal cause for this intracranial complication was the neglected compound depressed fracture. One was a newborn infant with left parietal abscess caused by a vacuum extraction. We have used the following methods of treating the abscesses: single burr hole aspiration in the newborn with an excellent result; repeated aspiration, with debridement of the depressed fracture, in 5 cases (1 death); aspiration with early subsequent excision, via craniotomy, in 7 cases (no death), and primary excision, via craniotomy, in 4 cases (1 death). The early subsequent excision of the abscess, 2 or 3 days after the initial aspiration, has proved in our experience very satisfactory. In cases with bone fragment into the abscess cavity the excision of the abscess is indicated. The cultured pus from the abscess cavity showed mixed flora (streptococci and staphylococci) in 7 cases; staphylococcus aureus in 4; staphylococcus epidermidis in 2, and no growth in 4 cases. Antibiotics play an important role in the treatment of post-traumatic brain abscesses.- - - - - - - - - - ranking = 0.66666666666667keywords = brain (Clic here for more details about this article) |
7/107. brain abscess as a complication of orthognathic surgery: diagnosis, management, and pathophysiology.We present what we believe is the first case of a brain abscess resulting from orthognathic surgery reported in the literature. Although recent advances have significantly improved the treatment of brain abscesses, delays in diagnosis lead to persistent high rates of mortality. Often, the initial symptoms are vague and nonspecific. Commonly, the neurologic status of the patient deteriorates significantly before suspicion is raised and a CT scan is obtained. This case report is intended to benefit all practitioners who participate in the perioperative care of orthognathic surgery patients. Although the occurrence of a brain abscess is rare, it is hoped that this case will heighten the awareness of clinicians to this potential complication.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
8/107. Primary CNS lymphoma associated with streptococcal abscess: an autopsy case.This report describes a case of streptococcal abscess in the nodules of a primary central nervous system (CNS) lymphoma. magnetic resonance imaging (MRI) of the brain revealed multiple lesions with ringlike enhancement over the bilateral frontal, right temporal, and left parietal lobes. On admission, acute brain edema occurred following angiography, which resulted in respiratory arrest. autopsy findings showed that the ringlike enhanced lesions on MRI were streptococcal abscesses localized in the lymphoma nodules. The lymphoma was classified as non-Hodgkin, diffuse large cells of B-cell lineage. No other lymphoma mass was found extracranially. An immunohistochemical study showed that the lymphoma cells were positive for leukocyte common antigen, Epstein-Barr virus, bax. and bcl-XL, and negative for L-26 and bcl-2. This case demonstrated that an opportunistic streptococcal abscess developed in primary CNS lymphoma in a patient without acquired immunodeficiency syndrome (AIDS), though a few similar cases have been reported in patients with AIDS.- - - - - - - - - - ranking = 0.92510169966817keywords = brain, central nervous system, nervous system (Clic here for more details about this article) |
9/107. brain abscess following delayed endoscopic removal of an initially asymptomatic esophageal coin.Brain abscesses are rare occurrences in pediatric patients, and making their diagnosis can be difficult. The two most commonly cited risk factors are otorhinologic infections and cyanotic congenital heart disease (CCHD). We present a 13-month-old child with a brain abscess who, 2 weeks prior, underwent rigid endoscopy for the extraction of a coin from the esophagus. We believe this to be the first such report of a brain abscess after rigid endoscopy for removal of an esophageal foreign body. In this case the esophageal coin was initially asymptomatic and had been present for weeks prior to removal. The potential association between delayed coin extraction and development of an intracranial infection, suggested by this report, may warrant investigation.- - - - - - - - - - ranking = 0.66666666666667keywords = brain (Clic here for more details about this article) |
10/107. Novel presentation and approach to management of hepatopulmonary syndrome with use of antimicrobial agents.A 44-year-old man with hepatitis c-associated liver cirrhosis, cyanosis, digital clubbing, and platypnea presented with left-side hemiplegia found to be due to a brain abscess. hepatopulmonary syndrome was diagnosed after demonstration of the presence of a massive intrapulmonary shunt. Although the anomalous vascular channel never was defined anatomically, follow-up studies confirmed the presence of a functional shunt. culture of a sample from the abscess yielded streptococcus intermedius. It was hypothesized that the patient's pulmonary vascular pathology was due, in large part, to chronic elevated levels of nitric oxide (a potent vasodilator thought to be generated by endotoxin absorbed from the gut). Treatment with oral norfloxacin was initiated on the basis of data that this antibiotic reduces endotoxemia and concomitant nitric oxide production in patients with cirrhosis. Four months after initiation of treatment, the patient's hypoxia had resolved.- - - - - - - - - - ranking = 0.33333333333333keywords = brain (Clic here for more details about this article) |
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