Pneumocephalus from gas-forming<i>Escherichia coli</i>subdural empyema

Adamides, Alexios A.; Goldschlager, Tony; Tulloch, Scott; McMahon, John

doi:10.1080/02688690701317839

Cited by 8 publications

(9 citation statements)

References 4 publications

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“…Of these gases, carbon dioxide diffuses rapidly into the surrounding tissues and is quickly absorbed because of its water solubility 15) . Other gases, except carbon dioxide, accumulate in tissues because of their reduced solubility in water 1 15) . The most common predisposing factor for gas-containing infections is reported to be DM 6) .…”

Section: Discussionmentioning

confidence: 99%

“…The most common predisposing factor for gas-containing infections is reported to be DM 6) . High blood glucose from poorly controlled DM and poor glycolysis at the tissue level in diabetic patients may contribute to increased glucose concentrations within the interstitial fluid 1 8) . Organisms then use the accumulated glucose to produce gases including carbon dioxide and hydrogen by means of anaerobic fermentation 8) .…”

Section: Discussionmentioning

confidence: 99%

“…Emphysematous (gas-containing or gas-forming) infections of the body, especially in the abdomen and pelvis, are potentially life-threatening conditions that require prompt diagnostic work-up and aggressive medical and/or surgical treatment 8) . In the neurosurgical field, although rare, cases of gas-containing brain abscess, subdural empyema, discitis, and spinal intradural abscess have been reported, and sometimes rapid clinical deterioration and even death occurred 1 3 4 15) . Gas-containing spinal epidural abscess (SEA) is also very rare and only a few cases have been reported 10 12 13 14) .…”

Section: Introductionmentioning

confidence: 99%

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Rapidly Progressive Gas-containing Lumbar Spinal Epidural Abscess

Bang

Cho

2015

Korean J Spine

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Gas-containing (emphysematous) infections of the abdomen, pelvis, and extremities are well-known disease entities, which can potentially be life-threatening. They require aggressive medical and often surgical treatment. In the neurosurgical field, some cases of gas-containing brain abscess and subdural empyema have been reported. Sometimes they progress rapidly and even can cause fatal outcome. However, gas-containing spinal epidural abscess has been rarely reported and clinical course is unknown. We report on a case of rapidly progressive gas-containing lumbar spinal epidural abscess due to Enterococcus faecalis in a 72-year-old male patient with diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rapidly Progressive Gas-containing Lumbar Spinal Epidural Abscess

Bang

Cho

2015

Korean J Spine

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“…Interestingly, eight of the nine reported cases involved older men, implying that age and sex may be potent risk factors. Six patients died within 1 month after diagnosis [4-6,8,10,12]. In five cases, extracranial infection had been recognized prior to the onset, suggesting that the hematogenous spread of E. coli might be a pivotal cause of intracranial abscess formation [4,5,7,9,11].…”

Section: Discussionmentioning

confidence: 99%

“…Preceding urinary tract infection was reported in three cases [4,7,11], and only one patient had a history of taking immunosuppressants (corticosteroids) [6]. These reported patients include one with a history of splenectomy [8], one with esophageal cancer undergoing radiochemotherapy [11], and two with diabetes [6,10]. These findings suggest that in addition to sex and age, immunosuppression may be another risk factor for intracranial E. coli infection.…”

Section: Discussionmentioning

confidence: 99%

Secondary brain abscess following simple renal cyst infection: a case report

et al. 2014

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BackgroundEscherichia coli (E. coli) is the most common causative bacteria of neonatal meningitis, but hematogenous intracranial E. coli infection is rare in adults. Moreover, intracranial abscess formation owing to E. coli, including brain abscesses and subdural empyema formation, is extremely rare. We herein present a case involving a patient with a brain abscess owing to E. coli following a simple renal cyst infection. A review of the literature is also presented.Case presentationA 77-year-old Japanese woman with a history of polymyalgia rheumatica was admitted to our hospital because of persistent fever, right flank pain, and pyuria. Intravenous antibiotics were administered; however, her level of consciousness deteriorated 6 days after admission. Contrast-enhanced magnetic resonance imaging showed a brain abscess in the left occipital lobe and pyogenic ventriculitis. Enhanced abdominal computed tomography revealed a right renal cyst with heterogeneous content. Culture of urine, blood, and aspirated pus from the infected cyst revealed E. coli with identical antibiotic sensitivity in all sites, suggesting that the cyst infection and subsequent bacteremia might have caused the brain abscess. The patient recovered after a 6-week course of meropenem.ConclusionThe prognosis of patients with E. coli-associated intracranial abscess is usually poor. Advanced age and immunosuppression may be potent risk factors for intracranial abscess formation owing to the hematogenous spread of E. coli.

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