Bacteriological analysis of pyogenic infections of the brain

Szuwart, Ulrich; Bennefeld, Harald

doi:10.1007/bf00383651

Cited by 22 publications

(10 citation statements)

References 17 publications

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“…are the most common causative agents found in pediatric brain abscesses, followed by gram-negative bacilli, including Klebsiella, Escherichia coli, Salmonella, Bacteroides, Haemophilus, and Proteus spp. 10,19,27,100,102,108,110 The authors of a recent report noted that Citrobacter was found predominantly in neonates, while fungal pathogens were found more frequently in immunocompromised patients. 37 …”

Section: Microbiological Characteristicsmentioning

confidence: 99%

Management of brain abscesses in children

Frazier¹,

Ahn²,

Jallo³

2008

FOC

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✓ Brain abscesses occur infrequently but continue to be problematic for the pediatric neurosurgical community. The incidence of brain abscesses in children has not changed much, although individual reports may show an increase or decrease in the number of reported cases depending on the patient population studied. An increase could be attributed to earlier detection due to advancements in imaging modalities and/or to an increase in the number of children with immunodeficient states caused by AIDS, chemotherapy for malignant lesions, and immunosuppressive therapy for organ transplantation. A decrease in the incidence of brain abscesses could be attributed to practices such as antibiotic treatment for otitis media, sinusitis, and/or prophylactic antimicrobial treatment for congenital heart disease in children. The morbidity and mortality rates associated with brain abscesses have not changed dramatically in the antibiotic and imaging era, and their preferred management can vary among healthcare providers. These lesions have been successfully treated by neurosurgeons. The causes of brain abscesses are highly variable in children, which is also the case in adults, but the predisposing factors in the pediatric population differ in prevalence. Cyanotic congenital heart disease, hematogenous dissemination, contiguous infection, and penetrating traumatic injuries are the most common causes of brain abscesses in children. In this review, the authors discuss the causes and medical and surgical management of brain abscesses in children.

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Section: Microbiological Characteristicsmentioning

confidence: 99%

Management of brain abscesses in children

Frazier¹,

Ahn²,

Jallo³

2008

FOC

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“…Streptococci constitute the majority of causative microorganisms, with estimates ranging from 52-80% of all isolated species (140,337,371,375). The single most common microorganism isolated in brain abscesses may be S. anginosus (Streptococcus millerz3 (371).…”

Section: Brain Abscessmentioning

confidence: 99%

“…The single most common microorganism isolated in brain abscesses may be S. anginosus (Streptococcus millerz3 (371). In a study of 1773 brain abscesses, 24% were due to facultative streptococci, 12% to anaerobic streptococci, 23% to staphylococci (primarily due to head trauma) 11% to P mirabitis (predominant in otitis media), 10% to Bacteroides, and 4% to E. coti (337). Other isolated organisms include H. injluenzae,Branhamella catarrhalis,I!…”

Section: Brain Abscessmentioning

confidence: 99%

Antibiotic prophylaxis and the medically compromised patient

Pallasch¹,

Slots²

1996

Periodontology 2000

145

108

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“…Mampalam and Rosenblum 18 reported positive cultures in 96% of the untreated patients, in contrast to 70% in those who have received any antimicrobial therapy before collecting the abscess content. In addition to that, abscesses with negative cultures have been connected with higher mortality rates 19 , probably due to inadequate antimicrobial therapy.…”

Section: Discussionmentioning

confidence: 99%

Brain abscess following ischemic stroke with secondary hemorrhage

Kraemer¹,

Worm²,

Faria³

et al. 2008

Arq. Neuro-Psiquiatr.

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Cerebral vascular events constitute the most common group of neurological diseases, and are usually followed by systemic infections, being pneumonia, urinary tract infection and sepsis the most frequent 1 . Brain abscess compromising the infarcted cerebral tissue is a rare condition 2,3 . It most frequently happens a few weeks after an infectious systemic insult, which had usually followed the ischemic stroke. There are only a few case reports on this subject in the literature. In spite of that, those patients with ischemic stroke should be considered at high risk of developing brain abscess, and should have this condition included in their differential diagnosis once neurologic or even systemic deterioration takes place following previous recovery. Cerebral ischemia is considered to be a predisposing factor for the genesis of brain abscess after stroke 4 . Due to impaired cerebral oxigenation and blood brain barrier disruption in the infarcted area, the formation of an abscess becomes feasible following bacteremia, a fact that has recently caught the attention of neurologists and neurosurgeons 2,3,5 . CASEA previously healthy 33-year-old white woman is admited to the emergency room complaining of severe right hemiparesis of acute onset and motor disphasia, which progressed to complete aphasia in a few minutes. Brain computed tomography (CT) revealed no abnormalities. Due to the hypothesis of acute obstruction of the left middle cerebral artery (MCA), a cerebral angiography was performed five hours after the onset of the symptoms, indicating oclusion of the distal portion of the left intracranial carotid artery, compromising both anterior and middle cerebral arteries. Intra-arterial thrombolytics were administered, with total reperfusion of the anterior cerebral artery territory. A MCA suboclusion (M2 segment) remained, despite multiple attempts to perform angioplasty with stent deployment. Patient was transferred to the intensive care unit (ICU) and was started on intravenous anticoagulants. About 24 hours after the procedure, patient developed anisocoria with left mydriasis, and tomographic evidence of hemispheric edema compromising the left MCA distribution with intracerebral hemorrhage and significant mass effect. A decompressive craniotomy was performed, and a ventricular catheter for intracranial pressure (ICP) measurement was placed (Fig 1).Elevated ICP was managed with mannitol and hypertonic saline. Four days after the ictus, patient developed fever (38 o C)with negative blood cultures. Pseudomonas aeruginosa and Staphylococcus aureus were then isolated in the tracheal aspirate, being both ciprofloxacin sensitive. Patient persisted febrile after seven days of antimicrobial therapy, and the previous germs were both once again isolated in the tracheal aspirate. Anaerobic gram positive cocci disposed in chains were identified in the blood culture; piperacilin and tazobactan for ciprofloxacin resistant pseudomonas were introduced, with favorable outcome. Seven weeks after the stroke, patient started with lo...

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Bacteriological analysis of pyogenic infections of the brain

Cited by 22 publications

References 17 publications

Management of brain abscesses in children

Management of brain abscesses in children

Antibiotic prophylaxis and the medically compromised patient

Brain abscess following ischemic stroke with secondary hemorrhage

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