Les abcès cérébraux (à propos de 80 cas)

Hilmani, S.; Riyahi, Sadegh; Ibahioin, K.; Naja, A.; Kamar, A. El; Azhari, A. El

doi:10.1016/j.neuchi.2008.10.012

Cited by 6 publications

(6 citation statements)

References 17 publications

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“…The diverse array of symptoms associated with these complications during the onset of disease and the extensive use of antibiotics prior to delivering appropriate therapeutic measures can often mask significant symptoms of intracranial complications [ 7 ]. This leads to a difficult and complex clinical manifestation (with regard to diagnosis and treatment) that may directly threaten the patient’s life and require prompt and definitive surgical treatment [ 8 – 10 ]. The purpose of this study was to present our results on the management of intracranial complications of sinusitis, specify the clinical manifestations of the pathologies and to propose an adequate management strategy.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous treatment of intracranial complications of paranasal sinusitis

Szyfter

Bartochowska

Borucki

et al. 2018

Eur Arch Otorhinolaryngol

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PurposeThe objective of this study was to analyse 51 patients with intracranial complications of sinusitis treated in the Department of Otolaryngology and Laryngeal Oncology at Poznań University of Medical Sciences from 1964 to 2016.Materials and methodsMales made up a significant portion of study participants at 70.5%. Treatment included simultaneous removal of inflammatory focal points in the paranasal sinuses and drainage of cerebral and epidural abscesses and subdural empyemas under the control of neuronavigation preceded by the implementation of broad-spectrum antibiotics continuously for 4 weeks. Seventy-three intracranial complications were found among 51 patients. Of the 51 patients, 25 had frontal lobe abscesses (including multiple abscesses). Other complications included the following: 16 epidural abscesses, 9 subdural empyemas, 15 meningitis cases, 3 intracerebral abscesses, 3 sinus thrombosis cases and 2 patients with cerebritis. Co-occurrence of these complications worsened the state of the patient and increased the duration of treatment. Patients with frontal lobe abscesses had a better prognosis and less pronounced neurological symptoms in recent years versus earlier treatment approaches.ConclusionsSimultaneous treatment of intracranial complications of sinusitis is an effective treatment method that has minimal burden for the patient. From 1964 to 1978, three deaths (17%) were reported among patients with these complications. Since 1978, no deaths were reported in the clinic.

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Section: Introductionmentioning

confidence: 99%

Simultaneous treatment of intracranial complications of paranasal sinusitis

Szyfter

Bartochowska

Borucki

et al. 2018

Eur Arch Otorhinolaryngol

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“…Several studies have demonstrated the involvement of bacteria of the oropharyngeal flora in the pathophysiology of many systemic, cardiovascular and cerebral diseases [3, 8]. Dental infection, and particularly periodontitis and dental caries are a rare but possible starting point for brain abscesses through haematogenous spread [1–6, 8, 11–14].…”

Section: Discussionmentioning

confidence: 99%

“…Pyogenic infections of the central nervous system (CNS) may be a consequence of traumatic or surgical events (10–20 %), bacterial invasion of the brain via neighbouring sites (20–30 %) or by hematogenous spread (20–40 %) [2, 3]. The incidence of brain abscesses is estimated to one to eight cases per 100 000 population per year [3, 4] with a masculine predominance [5–7]. Improvements in neuroimaging, neurosurgery and antibiotic therapy have led to new therapeutic strategies that have reduced mortality from 50 % in the 1970s to less than 10 % nowadays [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report

LAARIF

Schils

Lifrange

et al. 2023

Access Microbiology

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Introduction. Brain abscess is the most common focal infectious neurological injury. Until the nineteenth century this condition was fatal, however the development of neuroimaging for early diagnosis, neurosurgery and antibiotic therapy in the twentieth century has led to new therapeutic strategies decreasing mortality from 50 % in the 1970s to less than 10 % nowadays. In this context we report a case of brain abscess with a dental origin. Case report. A immunocompetent man without any addiction presented to the emergency department with dysarthria and frontal headache at home. The clinical examination was normal. Further investigations revealed a polymicrobial brain abscess as a consequence of an ear, nose or throat (ENT) infection with locoregional extension with a dental starting point involving Actinomyces israelii and Fusobacterium nucleatum . In spite of a rapid diagnosis and a neurosurgical management associated with an optimal treatment by a dual therapy made of ceftriaxone and metronidazole the patient unfortunately died. Conclusion. This case report shows that despite a low incidence and a good prognosis following the diagnosis, brain abscesses can lead to patient’s death. Thereby, when the patient’s condition and urgency allow, a thorough dental examination of patients with neurological signs following the recommendations would improve the diagnosis made by the clinician. The use of microbiological documentation, the respect of pre-analytical conditions, the interaction between the laboratory and the clinicians are indispensable for an optimal management of these pathologies.

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“…Dans certains cas, aucun germe n'est retrouvé. Hilmani dans sa série avait trouvé 45,6% de culture stérile [6] contre 57,1% dans notre cohorte. En général, les patients reçoivent des traitements plusieurs jours avant leur venue à l'hôpital.…”

Section: Discussionunclassified

Prise en charge des abcès cérébraux uniques à porte d'entrée non retrouvée (A propos d'une série de 7 cas)

Diallo¹,

Kourouma²,

Sogoba³

et al. 2020

Rev Mali Infectiol Microbiol

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Introduction : Les abcès cérébraux peuvent devenir graves s'ils sont non ou insuffisamment traités. La prise en charge inclue le traitement correct de la porte d'entrée. Celle-ci n'est pas toujours retrouvée. Nous rapportons notre expérience sur la prise en charge des abcès cérébraux à porte d'entrée non retrouvée à l'issue duquel nous proposerons un algorithme décisionnel de traitement. Patients et méthode : Il s'agit d'une étude retrospective et descriptive allant de novembre 2014 à décembre 2016. Elle a concerné les patients de tous âges traités dans le service de neurochirurgie du CHU Gabriel Touré pour un abcès cérébral chez qui le foyer initial n'a pas été retrouvé. Les paramètres cliniques, radiologiques et thérapeutiques ont été étudiés. Résultats :Durant notre période d'étude, les abcès cérébraux à point de départ non trouvé ont représenté 33,3% de tous les abcès cérébraux et 63,6% des abcès cérébraux opérés. L'âge moyen des patients était de 45 ans avec un sex ratio de 0,7. Tous nos patients étaient immunocompétents. La fièvre et l'hypertension intracranienne étaient les principaux signes. La lésion était de siège frontal et temporal principalement. Tous les patients ont bénéficié d'une ponction chirurgicale avec drainage d'abcès associé à une triantibiothérapie. L'évolution était défavorable dans 28,6% des cas (recollection d'abcès) et satisfaisante dans 71,4% des cas. La mortalité était nulle. Conclusion : La très bonne évolution clinique et radiologique après le traitement n'est une gage de la guérison d'un abcès du cerveau tant que le foyer infectieux initial n'est retrouvé et convenablement traité

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Les abcès cérébraux (à propos de 80 cas)

Cited by 6 publications

References 17 publications

Simultaneous treatment of intracranial complications of paranasal sinusitis

Simultaneous treatment of intracranial complications of paranasal sinusitis

Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report

Prise en charge des abcès cérébraux uniques à porte d'entrée non retrouvée (A propos d'une série de 7 cas)

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