Staphylococcal brain abscess following hematogenous seeding of an intracerebral hematoma

Bert, Frédéric; E, Maubec; Gardye, Carole; Branger, Catherine; Lambert-Zechovsky, N

doi:10.1007/bf02116536

Cited by 11 publications

(3 citation statements)

References 7 publications

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“…The haematoma observed in the left frontal lobe of our patient was most likely due his prematurity, and the abscess can be explained by bacterial seeding of the haematoma. This has been shown previously, though rarely, with other microorganisms [10]. Multiple areas of low density without ring enhancement, suggestive of cerebral abscesses, were also observed on the cerebral CT scans of two previously reported patients [4,5].…”

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confidence: 52%

A Case of Non-O:1 Vibrio cholerae Septicemia with Meningitis, Cerebral Abscess and Unilateral Hydrocephalus in a Preterm Baby

Ismail

Shafik

Al-Mutairi

2001

Eur J Clin Microbiol Infect Dis

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Non-O:1 Vibrio cholerae infections present clinically mainly as gastroenteritis (67%), septicemia (15%) or wound infection (8%) [1]. Seafood consumption is very common in the week preceding the onset of symptoms [1], but nosocomial infection may also occur [2]. Non-O:1 Vibrio cholerae septicemia is rare, particularly in the paediatric age group [1]. Eight cases of septicemia in children infected with this microorganism have been reported previously in the English-language literature [2,3,4,5,6,7,8,9], and three of them had meningitis as well [4,5,6] (1 had hydrocephalus, 1 had cerebral abscess-like lesions and 1 died). Reported here is an additional case of an infant who developed non-O:1 Vibrio cholerae septicemia with meningitis, cerebral abscess and unilateral hydrocephalus.The infant, male patient was born at 33 weeks gestation to a primigravida after an uneventful pregnancy and delivery, with a birth weight of 2.2 kg. The baby fed well and was discharged at the age of 24 h. At 60 h of age he was admitted to hospital with a 24-h history of poor feeding and recurrent, brief episodes of central and peripheral cyanosis in the preceding 1 h. Vomiting and diarrhea were absent. His weight was 2.01 kg, head circumference 29.5 cm, length 42 cm (all <50 th percentile), heart rate 140/min, respiratory rate 40/min, and temperature 36.3°C. He was observed to be sucking poorly and was hypotonic. The anterior fontanel was normal, and the physical examination was otherwise unremarkable. Blood and urine cultures were collected before ampicillin and cefotaxime were given intravenously (each in a dose of 200 mg/kg/day in 4 divided doses). Twelve hours later the patient had a generalized tonic-clonic convulsion. Intravenous phenobarbitone was instituted and a noncontrast cerebral computerized tomogram (CT) revealed a haematoma in the left frontal lobe with normalsized ventricles.Examination of the cerebrospinal fluid (CSF) revealed the following: total leukocyte count, 1,170/mm 3 (68% polymorphs, 32% lymphocytes); erythrocyte count, 12,150/mm 3 ; glucose level, 70 mg/dl (concomitant serum glucose, 106 mg/dl); protein level, 1,206 mg/dl. The latex agglutination test was negative for Escherichia coli, group B Streptococcus, Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae. Other investigations revealed the following: a total leukocyte count of 3,000/mm 3 (neutrophils, 40%; lymphocytes, 27%; monocytes, 23%); hemoglobin, 17.7 gm/dl; platelets, 241,000/mm 3 ; erythrocyte sedimentation rate, 2 mm/h; C-reactive protein, 19.5 mg/l (normal range, <8 mg/l); and total serum bilirubin, 11.7 mg/dl (direct 1). Liver and renal biochemical profiles remained normal. Blood culture grew oxidase-positive, gram-negative rods, which were identified biochemically as Vibrio cholerae and serologically as non-O:1 Vibrio cholerae (Central Microbiology Laboratory, Kuwait Ministry of Health). The organism was sensitive to ampicillin, cefotaxime and most of the other major antibiotics. The CSF, stool and urine cultures revealed no...

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supporting

confidence: 52%

A Case of Non-O:1 Vibrio cholerae Septicemia with Meningitis, Cerebral Abscess and Unilateral Hydrocephalus in a Preterm Baby

Ismail

Shafik

Al-Mutairi

2001

Eur J Clin Microbiol Infect Dis

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“…Only 19 cases of brain abscess at the site of previously untreated ICHs have been reported in literature (Table I) (1)(2)(3)(4)(5)(6)(7)(8)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Spontaneous ICHs are predominant in the basal ganglia and cause damage to the blood-brain barrier.…”

Section: Discussionmentioning

confidence: 99%

Brain abscess developing in a non-operated spontaneous intracerebral haemorrhage: case report and literature review.

Rigante

Tufo²,

Scoppettuolo³

et al. 2012

Turkish Neurosurgery

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Brain abscesses are a rare but potentially lethal neurological lesions, generally occurring after septic episodes in immunodeficient patients or complicating neurosurgical procedures. Even though they are known complications of surgically treated intracerebral haemorrhages (ICH), the presence of a brain abscess at the site of an untreated ICH is a rare event. Such cases may result from haematogenous spread from distant foci or contiguous sites and are often preceded by episodes of sepsis and local infection. Immunodeficiency, AIDS, age, diabetes mellitus and vitamin-K deficiency are predisposing factors. Abscess formation should be considered in case of clinical deterioration, headache, and any neurological deficit after febrile episodes. Early diagnosis with neuroradiological imaging, infection blood markers and microbiological identification of the causative pathogen is crucial for treatment with surgical drainage or excision and specific antibiotic therapy, which guarantee good outcome and long-term survival. In fact, while prompt diagnosis and treatment guarantee good outcome and long-term survival, morbidity and mortality are very high in case of misdiagnosis. We report a case of a 49-year old man presenting with a brain abscess 13 weeks after a spontaneous ICH, without previous episodes of sepsis and with a suspected septic arthritis 2 weeks after abscess drainage. KeywOrds: Brain abscess, Intracerebral haemorrhage, Stroke ÖZBeyin apseleri genellikle immün yetmezlikli hastalarda septik episodlar sonrasında gelişen veya nöroşirürji işlemlerinin komplikasyonları olarak görülen nadir ama ölümcül olabilen nörolojik lezyonlardır. Cerrahi olarak tedavi edilen intraserebral hemorajilerin bilinen komplikasyonları olsalar da tedavi edilmemiş bir intraserebral hemoraji bölgesinde bir beyin apsesi bulunması nadir bir durumdur. Bu tür olgular uzak odaklardan veya komşu bölgelerden hematojen yayılmanın sonucu olabilir ve sıklıkla öncelerinde sepsis ve yerel enfeksiyon episodları görülür. İmmünyetmezlik, AIDS, yaş, diabetes mellitus ve K vitamini eksikliği predispozan faktörlerdir. Apse oluşumu febril episodlardan sonra herhangi bir nörolojik defisit, başağrısı ve klinik durumda bozulma durumunda dikkate alınmalıdır. Nöroradyolojik testler, enfeksiyon kan işaretleri ve neden olan patojenin mikrobiyolojik olarak tanımlanması uzun dönemli iyi prognoz ve uzun dönemli sağkalımı garanti edecek şekilde cerrahi drenaj veya eksizyon ve spesifik antibiyotik tedavisiyle tedavi amacıyla erken tanı için şarttır. Hatta erken tanı ve tedavi iyi prognoz ve uzun dönemli sağkalımı garanti ederken yanlış tanı durumunda morbidite ve mortalite çok yüksektir. Daha önce sepsis episodu olmadan, spontan intraserebral kanamadan 13 hafta sonra beyin apsesiyle gelen ve apse drenajından 2 hafta sonra septik artrit durumundan şüphelenilen 49 yaşında bir erkek hastayı sunuyoruz.

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“…The most commonly found pathogens are streptococci and staphylococci. A 1993 study suggested that in the case of staphylococcal bacteraemia, metastatic foci occur in up to 27% of cases 11 . It is thought that haematomas may represent areas of impaired immunity and are therefore favourable sites of infection during bacteraemia 12,13 .…”

Section: Discussionmentioning

confidence: 99%

Pyogenic abscess complicating a resolving cerebral haematoma secondary to a cavernous haemangioma: Computed tomography and magnetic resonance imaging findings

Borsaru

Naidoo

2005

Australasian Radiology

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A case is discussed of a brain abscess complicating an intracerebral haemorrhage occurring in a cavernous haemangioma. A young child presented with focal seizures as a result of a large intracerebral haemorrhage, occurring in a cavernous haemangioma. The only clue to the underlying vascular malformation was the presence of an associated developmental venous anomaly. The case was complicated by the development of a brain abscess at the site of the intracranial haematoma. The CT and MRI findings are discussed.

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Staphylococcal brain abscess following hematogenous seeding of an intracerebral hematoma

Cited by 11 publications

References 7 publications

A Case of Non-O:1 Vibrio cholerae Septicemia with Meningitis, Cerebral Abscess and Unilateral Hydrocephalus in a Preterm Baby

A Case of Non-O:1 Vibrio cholerae Septicemia with Meningitis, Cerebral Abscess and Unilateral Hydrocephalus in a Preterm Baby

Brain abscess developing in a non-operated spontaneous intracerebral haemorrhage: case report and literature review.

Pyogenic abscess complicating a resolving cerebral haematoma secondary to a cavernous haemangioma: Computed tomography and magnetic resonance imaging findings

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