Recurrent tuberculous cerebellar abscess: A case study and review of the literature

Cissé, Yakhya; Sy, El Hadji Cheikh Ndiaye; Diop, Abdoulaye; Sarr, Habibou; Barry, Louncény Fatoumata; Nzisabira, Jean Michel

doi:10.1016/j.ijscr.2021.105832

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Definitive diagnosis is by biopsy or culture and is usually difficult and delayed. (iv) Tuberculosis: Tuberculosis is responsible for almost all cases of intracranial tubercular infection.Patients may present acutely with fever, headache, focal neurological deficits corresponding to the site of the tuberculous brain abscess, with surrounding edema, or with signs and symptoms of raised intracranial pressure, which deteriorate more rapidly in comparison to patients with tuberculomas [ 30 ]. The radiological presentation usually is a uni- or multi-loculated lesion with a thin and uniform capsule, although it may be indistinguishable from pyogenic abscesses [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Case report: isolated prevotella intermedia causing intracranial infection detected using metagenomic next generation sequencing

Ye,

He,

et al. 2023

BMC Neurol

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Background Isolated Prevotella intermedia, a rare gram-negative, rod-shaped, anaerobic bacterium, is rarely detected in clinical practice. It has been associated with infections of the oral cavity and female genital tract, but has never been detected in cerebrospinal fluid (CSF) of patients in China. Accurate detection of causative pathogens is still an arduous task owing to the difficult conditions of anaerobic bacterial culture. Isolated Prevotella intermedia can be detected by metagenomic next generation sequencing (mNGS) of the CSF. Correct diagnosis and antibiotic treatment can help patients avoid life-threatening events. Case presentation Herein, we describe the case of a 64-year-old Chinese woman who presented with typical features of meningoencephalitis. Routine CSF culture failed to identify the causative pathogen. Isolated Prevotella intermedia was detected by mNGS, and the patient was treated with antibacterial agents including ceftriaxone, vancomycin, moxifloxacin, meropenem, metronidazole, and linezolid. The patient underwent surgical treatment for abscess of left frontal parietal lobe, which was observed on magnetic resonance imaging (MRI) and was suspected to be caused by Prevotella intermedia. It was further confirmed that it was a secondary infection from the oral cavity, and the possible etiology might have been dental surgery. Treatment was rendered to the patient based on metagenomic test result, and her condition improved after two months. Conclusions This case highlights the role of mNGS in accurate diagnosis of patients with central nervous system infection. In particular, mNGS can be used to identify rare pathogens and confirm the diagnosis in patients with unknown etiology.

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Section: Discussionmentioning

confidence: 99%

Case report: isolated prevotella intermedia causing intracranial infection detected using metagenomic next generation sequencing

Ye,

He,

et al. 2023

BMC Neurol

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“…Tuberculous brain abscess is a rare disorder seen in both immunocompetent and immunocompromised individuals (1,2) . For confirming true tuberculous abscess, presence of an abscess in the brain parenchyma, histology confirming vascular granulation tissue in the abscess wall and bacteriologic samples proving tuberculosis is required (3) . Tuberculous brain abscess can be diagnosed only through histopathologic examination as neuroimaging is non-specific.…”

Section: Introductionmentioning

confidence: 99%

Differentiating Pyogenic Brain Abscesses and Tuberculous using Magnetization Transfer MR Imaging and in Vivo Proton MR Spectroscopy

Islam¹,

Nighat²,

Firdous³

et al. 2022

PJMHS

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Objective: To find whether in vivo proton MR spectroscopy and magnetization transfer (MT) MR imaging can be used to differentiate between tuberculous brain abscess and pyogenic brain abscess. Study Design: Retrospective Place and duration: Radiology Department of Ibn_e_Sina Hospital Multan from January 2021 to January 2022. Methodology: The study included 15 subjects with brain abscesses who underwent in vivo MR spectroscopy, MT MR imaging and conventional MR imaging. Those with other systemic diseases were excluded. These techniques were also performed on 10 sex and age-matched control subjects for comparing MT ratios in normal and diseased parenchymal locations. 13 tuberculous abscesses were found in 4 patients, and 20 pyogenic abscesses were found in 11 patients. MT MR imaging and in vivo MR spectroscopy were used to evaluate suspected brain abscesses. Results: The mean MT ratio of the pyogenic brain abscesses was 25.55±1.60.MR spectroscopy showed that in pyogenic abscesses level of amino acids (valine, isoleucine, leucine) was 0.8 ppm and lipid and lactate was 1.2 ppm. Additionally, acetate, 1.91 ppm; glycine, 3.55 ppm; succinate,2.40 ppm and alanine, 1.47 pm were also seen. Four patients had 13 tuberculous abscesses. The mean MT ratio obtained from tuberculous abscesses was 19.87±1.54, which was significantly lower compared to the cortical grey matter, deep grey matter, white matter and pyogenic abscess (p<.001). Conclusion: MT ratios in tuberculous brain abscesses were lower than in pyogenic abscesses. In vivo, MR spectroscopy in pyogenic abscesses did not show amino acids. Tuberculous brain abscess can be differentiated from the pyogenic abscess by using both in vivo MR spectroscopy and MT MR imaging. Keywords: Pyogenic brain abscess, tuberculous brain abscess, MR spectroscopy

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Recurrent tuberculous cerebellar abscess: A case study and review of the literature

Cited by 2 publications

References 12 publications

Case report: isolated prevotella intermedia causing intracranial infection detected using metagenomic next generation sequencing

Case report: isolated prevotella intermedia causing intracranial infection detected using metagenomic next generation sequencing

Differentiating Pyogenic Brain Abscesses and Tuberculous using Magnetization Transfer MR Imaging and in Vivo Proton MR Spectroscopy

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