Use of an Intracranial Drain as a Conduit for Treatment of an Intracranial Streptococcus intermedius Abscess

Abstract

Brain abscesses are difficult to manage clinically and often result in a poor outcome. Although surgical and medical therapeutics have progressed, there are still challenges that make treating intracranial abscesses problematic. One of these treatment barriers is the poor penetration of intravenous antibiotics to the infection source through the blood-brain barrier. In this case report, we will discuss the use of a surgical drain as a conduit for direct antibiotic administration for a rare, recurrent Streptococcus intermedius infection. This technique allows us to bypass the blood-brain barrier while also reducing the systemic effects of antibiotics. When used in conjunction with craniotomy and resection, direct antibiotic administration via a surgical drain proved to be effective at treating our patient's abscess and preventing recurrence.

Osteomyelitis caused by Streptococcus intermedius in immunocompetent adults — a case report and systematic literature review

“…To limit and/or relieve abscess formation, surgical debridement was performed in two cases (including ours). In addition, as Streptococcus intermedius has been commonly associated with recurrent abscesses [ 1 , 16 , 17 ], it was noticed that multiple surgical debridements were often required. Follow-up ranged from 2 weeks to more than 6 months.…”

Risk Factors for Central Nervous System Infections After Craniotomy

“…Extracranial pathogens can enter the brain easily through the channel and increase the possibility of intracranial infection. 37

Figure 4 Bacteria enter the brain through the drainage tube. The drainage tube is used to draw out blood and fluids.

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