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Cerebral syphilitic gumma misdiagnosed as brain abscess: A case report
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作者 Li-Kun Mu Li-Feng Cheng +2 位作者 Jing Ye Meng-Yan Zhao Jin-Long Wang 《World Journal of Clinical Cases》 SCIE 2024年第3期650-656,共7页
BACKGROUND Cerebral syphilitic gumma is a relatively rare clinical disease.Its clinical manifest-ations are non-specific,and the imaging manifestations are similar to other in-tracranial occupying lesions,often misdia... BACKGROUND Cerebral syphilitic gumma is a relatively rare clinical disease.Its clinical manifest-ations are non-specific,and the imaging manifestations are similar to other in-tracranial occupying lesions,often misdiagnosed as tumors or abscesses.There are few reports on this disease in the relevant literature.To our knowledge,we have reported the first case of cerebral syphilitic gumma misdiagnosed as a brain abscess.We report this case and provide useful information for clinical doctors on neurosyphilis diseases.CASE SUMMARY We report the case to explore the diagnostic essentials of cerebral syphilitic gumma and attempt to mitigate the rates of misdiagnosis and missed diagnosis by equipping physicians with knowledge of neurosyphilis characteristics.The cli-nical diagnosis and treatment of a patient with cerebral syphilitic gumma were reported.Clinical manifestations,classifications,and diagnostic points were retro-spectively analyzed.The patient was admitted to the hospital with fever and limb weakness.Brain magnetic resonance imaging showed multiple space-occupying lesions and a positive serum Treponema pallidum gelatin agglutination test.The patient was misdiagnosed as having a brain abscess and underwent a craniotomy.A postoperative pathological diagnosis of syphilis gumma was made.The patient improved and was discharged after penicillin anti-syphilis treatment.Follow-up recovery was satisfactory.CONCLUSION Cerebral syphilitic gumma is rare in clinical practice,and it is often misdiagnosed and missed.Clinical diagnosis should be considered in combination with multiple examinations. 展开更多
关键词 NEUROSYPHILIS Cerebral syphilitic gumma brain abscess MISDIAGNOSIS TREATMENT Case report
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Brain abscess from oral microbiota approached by metagenomic next-generation sequencing: A case report and review of literature
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作者 Xue-Min Zhu Chun-Xia Dong +2 位作者 Lei Xie Hao-Xin Liu Huai-Qiang Hu 《World Journal of Clinical Cases》 SCIE 2024年第3期616-622,共7页
BACKGROUND Brain abscess is a serious and potentially fatal disease caused primarily by microbial infection.Although progress has been made in the diagnosis and treatment of brain abscesses,the diagnostic timeliness o... BACKGROUND Brain abscess is a serious and potentially fatal disease caused primarily by microbial infection.Although progress has been made in the diagnosis and treatment of brain abscesses,the diagnostic timeliness of pathogens needs to be improved.CASE SUMMARY We report the case of a 54-year-old male with a brain abscess caused by oral bacteria.The patient recovered well after receiving a combination of metagenomic next-generation sequencing(mNGS)-assisted guided medication and surgery.CONCLUSION Therefore,mNGS may be widely applied to identify the pathogenic microor-ganisms of brain abscesses and guide precision medicine. 展开更多
关键词 brain abscess Metagenomic next-generation sequencing PERIODONTITIS Oral bacteria Precision medicine Case report
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Brain abscess caused by Streptococcus anginosus group:Three case reports
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作者 Si-Di Tan Ming-Hui Li 《World Journal of Clinical Cases》 SCIE 2024年第17期3243-3252,共10页
BACKGROUND This case series investigated the clinical manifestations,diagnoses,and treatment of cerebral abscesses caused by Streptococcus anginosus.We retrospectively analyzed the clinical characteristics and outcome... BACKGROUND This case series investigated the clinical manifestations,diagnoses,and treatment of cerebral abscesses caused by Streptococcus anginosus.We retrospectively analyzed the clinical characteristics and outcomes of three cases of cerebral abscesses caused by Streptococcus anginosus and conducted a comprehensive review of relevant literature.CASE SUMMARY Case 1 presented with a history of left otitis media and exhibited high fever,confusion,and vomiting as primary symptoms.Postoperative pus culture indicated a brain abscess caused by Streptococcus constellatus infection.Case 2 experienced dizziness for two days as the primary symptom.Postoperative pus culture suggested an intermediate streptococcal brain abscess.Case 3:Enhanced head magnetic resonance imaging(MRI)and diffusion-weighted imaging revealed occupancy of the left temporal lobe,initially suspected to be a metastatic tumor.However,a postoperative pus culture confirmed the presence of a brain abscess caused by Streptococcus anginosus infection.The three cases presented in this case series were all patients with community-acquired brain abscesses resulting from angina caused by Streptococcus group infection.All three patients demonstrated sensitivity to penicillin,ceftriaxone,vancomycin,linezolid,chloramphenicol,and levofloxacin.Successful treatment was achieved through stereotaxic puncture,drainage,and ceftriaxone administration with a six-week course of antibiotics.CONCLUSION Preoperative enhanced head MRI plays a critical role in distinguishing brain tumors from abscesses.Selecting the correct early diagnostic methods for brain abscesses and providing timely intervention are very important.This case series was in accordance with the CARE guidelines. 展开更多
关键词 Streptococcus anginosus group Cerebral abscess Early diagnosis of a brain abscess Plasma microbial cell-free DNA Next-generation sequencing Case report
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Isolated cerebral mucormycosis that looks like stroke and brain abscess:A case report and review of the literature 被引量:1
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作者 Cai-Hong Chen Jing-Nan Chen +1 位作者 Hang-Gen Du Dong-Liang Guo 《World Journal of Clinical Cases》 SCIE 2023年第7期1560-1568,共9页
BACKGROUND Cerebral mucormycosis is an infectious disease of the brain caused by fungi of the order Mucorales.These infections are rarely encountered in clinical practice and are often misdiagnosed as cerebral infarct... BACKGROUND Cerebral mucormycosis is an infectious disease of the brain caused by fungi of the order Mucorales.These infections are rarely encountered in clinical practice and are often misdiagnosed as cerebral infarction or brain abscess.Increased mortality due to cerebral mucormycosis is closely related to delayed diagnosis and treatment,both of which present unique challenges for clinicians.CASE SUMMARY Cerebral mucormycosis is generally secondary to sinus disease or other disseminated disease.However,in this retrospective study,we report and analyze a case of isolated cerebral mucormycosis.CONCLUSION The constellation of symptoms including headaches,fever,hemiplegia,and changes in mental status taken together with clinical findings of cerebral infarction and brain abscess should raise the possibility of a brain fungal infection.Early diagnosis and prompt initiation of antifungal therapy along with surgery can improve patient survival. 展开更多
关键词 Cerebral mucormycosis STROKE brain abscess Diagnosis Treatment Case report
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Brainstem abscesses caused by Listeria monocytogenes:A case report 被引量:1
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作者 Jie Wang Yu-Chen Li +2 位作者 Ke-Yu Yang Jing Wang Zan Dong 《World Journal of Clinical Cases》 SCIE 2022年第22期7924-7930,共7页
BACKGROUNDIntracranial Listeria infections are common in newborns and immunocompromisedindividuals, but brainstem abscesses are rare.CASE SUMMARYWe report a rare case of brainstem abscesses caused by Listeria monocyto... BACKGROUNDIntracranial Listeria infections are common in newborns and immunocompromisedindividuals, but brainstem abscesses are rare.CASE SUMMARYWe report a rare case of brainstem abscesses caused by Listeria monocytogenes in apreviously healthy adult patient. The patient’s magnetic resonance imagingexamination showed multiple brain abscesses, and his second cerebrospinal fluidculture test indicated the presence of Listeria monocytogenes. Despite earlyempirical therapy, the patient’s condition progressively deteriorated. Because thepatient's abscesses were located in the brainstem and multiple lobes, surgery wasnot possible. The patient died 40 d after admission.CONCLUSIONThis case highlights the importance of rational clinical use of drugs to avoidpotentially serious infectious complications. 展开更多
关键词 Listeria monocytogenes brainstem abscesses DRUG brain MRI Therapy PROGNOSIS Case report
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Scalp block for brain abscess drainage in a patient with uncorrected tetralogy of Fallot
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作者 Sameer Sethi Sonia Kapil 《World Journal of Clinical Cases》 SCIE 2014年第12期934-937,共4页
We report a case of an 11-year-old boy with diagnosed but uncorrected tetralogy of Fallot presented to us for brain abscess drainage. The child was managed successfully with scalp block with sedation.
关键词 Tetralogy of Fallot brain abscess KETAMINE SCALP BLOCK CONGENITAL HEART disease
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Rare case of cryptogenic brain abscess caused by Raoultella ornithinolityca
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作者 Marianna Luongo 《World Journal of Clinical Cases》 SCIE 2017年第7期299-302,共4页
Cerebral abscess is a potentially fatal neurosurgical condition,despite improvements in technology,new antimicrobial agents and modern neurosurgical instruments and techniques.I report the case of a 64-yearold woman,a... Cerebral abscess is a potentially fatal neurosurgical condition,despite improvements in technology,new antimicrobial agents and modern neurosurgical instruments and techniques.I report the case of a 64-yearold woman,affected by a right frontobasal brain abscess,compressing the homolateral frontal horn of lateral ventricle,with a second mass partially occupying the right orbital cavity.She presented also with inflammatory sinusopathy involving the right maxillary,ethmoid and frontal sinuses.After 14 d of clinical observation and antimicrobial therapy,the patient received a computed tomography scan,which showed growth of the cerebral mass,with a ring of peripheral contrast enhancement and surrounding edema.She promptly underwent neurosurgical treatment and recovered well,except for the sight in her right eye,which remained compromised,as before the operation.This is believed to be the first case of cryptogenic cerebral abscess caused by Raoultella ornithinolityca isolated from the brain,with more than 1-year follow-up. 展开更多
关键词 brain abscess HEADACHE Raoultel a ornithinolityca Visual loss
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Clinical and Radiological Features in the Cases with Cryptogenic Brain Abscess in Association with Patent Foramen Ovale: A Case Report and Review of the Literature
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作者 Masayuki Sugie Takahiro Jimi +1 位作者 Yojiro Kashimura Hiroo Ichikawa 《International Journal of Clinical Medicine》 2014年第21期1400-1404,共5页
Brain abscesses are commonly associated with cranial trauma, a contiguous focus of infection, or hematogenous spread from a distant focus. However, no predisposing factors are identified in approximately 4% of the cas... Brain abscesses are commonly associated with cranial trauma, a contiguous focus of infection, or hematogenous spread from a distant focus. However, no predisposing factors are identified in approximately 4% of the cases, being recognized as a cryptogenic brain abscess (CBA). Here we report a patient with a CBA in the left occipital lobe presumably caused by a periodontal disease. The patient displayed a patent foramen ovale (PFO), through which a spontaneous right-to-left shunt was revealed with transesophageal echocardiography. A literature review indicated that in contrast to cases of general brain abscesses, patients with CBA were older and mostly had dental disorders represented by periodontal diseases and a large PFO. In these patients, the abscess was located predominantly in the posterior circulation area, and their prognosis was worse than that of general cases. Consequently, we emphasize the significance of screening for PFO in cases of advanced age with CBA in the posterior circulation region. Furthermore, to avoid neurological sequelae, we suggest immediate surgical drainage with antibiotic administration and maintenance of oral hygiene. 展开更多
关键词 CRYPTOGENIC brain abscess PATENT Foramen Ovale POSTERIOR CIRCULATION Area AGING
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Brain Abscess after COVID-19: Case Report
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作者 Natalia Chilinque Zambão da Silva Patrícia Yvonne Maciel Pinheiro +1 位作者 Joao Gabriel Dib Farinhas Luiz Eduardo Dalmeida Machado Sampaio 《Advances in Infectious Diseases》 CAS 2023年第1期77-80,共4页
As the COVID-19 pandemic progresses, complications and unusual presentations of the disease have been described. Among them, the involvement of distinct parts of the neuroaxis. We report a rare case of brain abscess i... As the COVID-19 pandemic progresses, complications and unusual presentations of the disease have been described. Among them, the involvement of distinct parts of the neuroaxis. We report a rare case of brain abscess in elderly after SARS-Cov-2 infection readmitted in our health unit. Patient was treated with ceftriaxone, metronidazole and vancomycin with good clinical and therapeutic response. The satisfactory conduct of the case was only possible by the involvement of a multiprofessional team, which sought early diagnosis, surgical intervention and adequate duration of treatment. 展开更多
关键词 brain abscess BIOPSY COVID-19
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Perioperative Nursing of a Case of Right Temporal Lobe Brain Abscess Ruptured into the Ventricle
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作者 Xiaoqun Chen Shuo Yang +1 位作者 Qinqin Zhao Zhihuan Zhou 《Journal of Cancer Therapy》 2021年第5期233-239,共7页
<strong>Objective:</strong><span style="font-family:Verdana;"> To explore the perioperative nursing method of brain abscess</span><span style="font-family:;" "="... <strong>Objective:</strong><span style="font-family:Verdana;"> To explore the perioperative nursing method of brain abscess</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> breaking into the ventricle. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">By reviewing the clinical data of 1 case of right temporal lobe brain abscess into the ventricle, the effective nursing me</span><span><span style="font-family:Verdana;">thods were summarized. </span><b><span style="font-family:Verdana;">Results</span></b></span></span><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> The patient’s condition was advanced</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> quickly, and the diagnosis was treated in time to avoid brain hernia, but the treatment was difficult because of the critical condition.</span><b><span style="font-family:Verdana;"> Conclusion:</span></b><span style="font-family:Verdana;"> Brain abscess is a very serious intracranial infectious disease. It is of great significance </span><span style="font-family:Verdana;">to observe the changes in patients’ condition and take effective nursing</span><span style="font-family:Verdana;"> measures.</span></span> 展开更多
关键词 brain abscess VENTRICLE Perioperative Nursing
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Infective Endocarditis in Tetralogy of Fallot Complicating Brain Abscess—A Case Report
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作者 Ramachandran Muthiah 《Case Reports in Clinical Medicine》 2019年第5期105-126,共22页
Aim: To report a case of solitary, parietal lobe abscess in a boy, aged 16 years in Tetralogy of Fallot. Introduction: Infective endocarditis is a serious and fatal complication in congenital heart disease. Following ... Aim: To report a case of solitary, parietal lobe abscess in a boy, aged 16 years in Tetralogy of Fallot. Introduction: Infective endocarditis is a serious and fatal complication in congenital heart disease. Following bacterial endocarditis, ventricular septal defect (VSD) and Tetralogy of Fallot (TOF) have less morbidity and higher survival rate in children. Neurological complications were recognized in 20% of cases and brain abscess is a serious infection of brain parenchyma as a result of seeding of infective pathogens in the shunted blood from the right side of the heart. Case Report: A 16 year old boy had Tetralogy of Fallot, presented with altered sensorium of sudden onset. Echocardiography revealed a large vegetation, attached to the ventricular septum and a large VSD with overriding of aorta. CT brain revealed a large abscess cavity in the parietal lobe, which was evacuated by aspiration and treated with antibiotics. Conclusion: Any patient presented with altered sensorium in cyanotic congenital heart disease must be evaluated with CT scanning for brain abscess and also check hematocrit to rule out hyperviscosity syndrome. Lumbar puncture has been considered hazardous in patients with brain abscess and usually performed under a strong suspicion of meningitis or ventriculitis in the absence of increased intracranial pressure. 展开更多
关键词 Tetralogy of Fallot VEGETATION brain abscess FIVE Component Therapy SURGICAL ASPIRATION
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Brain Abscess Surgery Outcome: A Comparison between Craniotomy with Membrane Excision versus Burr Hole Aspiration
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作者 Babiker Sirelkhatim Hassan Ali Abubakr Darrag Salim Ahmed +1 位作者 Mohammed Awad Elzain Fawaz Eljili Marhoom Abdelradi 《Open Journal of Modern Neurosurgery》 2023年第2期74-93,共20页
Introduction: Brain abscess represents 8% of intracranial masses in developing countries. Despite the advances in neuro-imaging, still, the diagnosis of brain abscess is difficult and may need a biopsy in most cases t... Introduction: Brain abscess represents 8% of intracranial masses in developing countries. Despite the advances in neuro-imaging, still, the diagnosis of brain abscess is difficult and may need a biopsy in most cases to verify the diagnosis because may even lead to death. CT scan with contrast is a good tool for diagnosing and localizing brain abscesses in late stages, however, it is difficult to diagnose them in the early stages. The development of MRI helps to more accurately diagnose brain abscess. Surgical management of brain abscesses is either medical or surgical through craniotomy or burr holes. Indications of each are still a point of debate among most neurosurgeons. Methodology: This is a descriptive longitudinal prospective study to compare the outcomes of two surgical procedures used in The National Centre for Neurological Sciences-Khartoum-Sudan (NCNS) from 2012 to 2015, craniotomy and excision of the abscess membrane versus burr hole and aspiration of brain abscess in terms of duration of hospitalization, length of antibiotic use, recurrence rate, number of images needed for follow-up, and the final postoperative early and late outcomes. The data was collected through a designed questionnaire and was then analyzed using SPSS version 20. No significant ethical approval was required for this study. Results: Fifty-four patients were operated on through craniotomy (29/54) and burr hole (25/54). Their ages ranged from 1 year to 53 years with an average presentation at 13 years of age. Most patients presented with fever (23.1%), convulsions (16%), vomiting (16.7%) and headache (15.4%). The mean of illness for both groups was almost 2 months. The majority of patients in this study were having no risk factors (38.9%) while the major risk factors seen were cardiac diseases (14.8%), neurosurgical procedures (13%) and otitis media (11.1%). As most patients presented late, the diagnosis of most was made using CT brain with contrast (83.3%). In most of the patients (85.2%) there were no organisms separated in the culture. 8/54 patients had positive cultures, 7/8 were bacterial and only one (1/8) was fungal. Most patients received antibiotics for 45 days postoperatively in both craniotomy and burr hole groups. When both groups were compared, those operated with craniotomy were found to have a relatively higher length of hospital stay, however, no significant difference was found between both groups. Also, it was found that those operated on with craniotomy had a high cure rate and less recurrence in comparison with burr hole group. Deterioration and death were significantly higher among craniotomy group. Only CT brain was used as the imaging modality of choice for follow-up in both groups for 4 months’ duration and it was noted that complete evacuation was significantly higher among craniotomy group while remnants were higher among burr hole group. Conclusion: Brain abscess is still a challenging condition for neurosurgeons in Sudan. The limited number of Sudanese neurosurgeons, neurosurgical centers and diagnostic facilities contributed to delay in diagnosing brain abscess in most patients. It is important to design a strict protocol and precautions for any neurosurgical operation or bedside procedure to prevent infection and subsequent brain abscess development. CT brain with contrast is a good imaging tool for assessing the size, site and stage of brain abscesses. No significant difference between craniotomy or burr hole for clearance from brain abscess in terms of antibiotic used or duration of hospital stay. However, burr hole aspiration is associated with higher rates of recurrences. On the other hand, craniotomy and excision have relatively higher neurologic morbidity postoperative with expectantly higher post-operative hospitalization but no differences in the final outcome. Therefore, the selection of surgical technique should be individualized in each case based on the abscess site size source patient fitness for surgery and neurosurgeon’s preference. 展开更多
关键词 brain abscess Surgery OUTCOME Comparison of Surgery of brain abscess Craniotomy versus Burrhole
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Neonatal Brain Abscess:Case Report of 12 Cases and Literature Review
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作者 Nan Peng Zhen Chen Qi Lu 《Journal of Clinical and Nursing Research》 2022年第6期97-104,共8页
Objective:To investigate the etiological characteristics,clinical manifestations,and early identification methods of neonatal brain abscess.Methods:The baseline characteristics,clinical manifestations,and laboratory r... Objective:To investigate the etiological characteristics,clinical manifestations,and early identification methods of neonatal brain abscess.Methods:The baseline characteristics,clinical manifestations,and laboratory results of 12 neonatal brain abscess cases were retrospectively analyzed.Results:The clinical manifestations were fever,convulsion,and lethargy.A small number of them had respiratory and circulatory failure.The diagnosis made was based on imaging examination.All 12 cases were confirmed by cranial enhanced computed tomography(CT)or magnetic resonance imaging(MRI).Blood cultures of 9 cases were positive,with Escherichia coli in 6 cases,β-hemolytic Streptococcus in 1 case,methicillin-resistant Staphylococcus aureus in 1 case,and Enterococcus faecium in 1 case.However,only 3 of them had positive cerebrospinal fluid(CSF)cultures.All the 12 neonates were treated with antibiotic therapy upon admission,with only 3 cases treated with surgery.Among them,4 recovered and were discharged,while the remaining 8 discontinued their therapy.Conclusion:Escherichia coli is the most common pathogen of neonatal brain abscess in our study.The clinical manifestations of neonatal brain abscess are atypical,and the prognosis is poor.Respiratory and circulatory failure in children with intracranial infection may indicate the presence of brain abscess.For children with suspected brain abscess,cranial enhanced CT or MRI should be performed as soon as possible to make an early diagnosis.The prevention of brain abscess should be prioritized;neonates with sepsis or meningitis should receive prompt and strong antibiotic therapy in an effort to prevent the development of brain abscess. 展开更多
关键词 brain abscess Clinical manifestations Enhanced CT or MRI Antibiotic
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Spontaneous cerebral abscess due to Bacillus subtilis in an immunocompetent male patient: A case report and review of literature 被引量:1
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作者 Ioannis Tsonis Lydia Karamani +5 位作者 Panagiota Xaplanteri Fevronia Kolonitsiou Petros Zampakis Georgios Gatzounis Markos Marangos Stelios F Assimakopoulos 《World Journal of Clinical Cases》 SCIE 2018年第16期1169-1174,共6页
BACKGROUND Bacillus subtilis(B. subtilis) is considered a nonpathogenic microorganism of the genus Bacillus and a common laboratory contaminant. Only scarce reports of B. subtilis central nervous system infection have... BACKGROUND Bacillus subtilis(B. subtilis) is considered a nonpathogenic microorganism of the genus Bacillus and a common laboratory contaminant. Only scarce reports of B. subtilis central nervous system infection have been reported, mainly in the form of pyogenic meningitis,usually in cases of direct inoculation by trauma or iatrogenically.CASE SUMMARY A 51-year-old man, with a free previous medical history, presented to the Emergency Department of our hospital complaining of recurrent episodes of left upper limb weakness, during the last month, which had been worsened the last 48 h. During his presentation in Emergency Department he experienced a generalized tonic-clonic grand mal seizure. Brain magnetic resonance imaging(MRI) scan with intravenous Gadolinium revealed a 3.3 cm × 2.7 cm lesion at the right parietal lobe surrounded by mild vasogenic edema, which included the posterior central gyrus. The core of the lesion showed relatively homogenous restricted diffusion. Post Gadolinium T1 W1 image, revealed a ring-shaped enhancement. Due to the imaging findings, brain abscess was our primary consideration. Detailed examination for clinical signs of infectious foci revealed only poor oral hygiene with severe tooth decay and periodontal disease, but without detection of dental abscess. The patient underwent surgical treatment with right parietal craniotomy and total excision of the lesion. Pus and capsule tissue grew B. subtilis and according to antibiogram intravenous ceftriaxone 2 g bids was administered for 4 wk. The patient remained asymptomatic and follow-up MRI scan two months after operation showed complete removal of the abscess.CONCLUSION This case highlights the ultimate importance of appropriate oral hygiene and dental care to avoid potentially serious infectious complications and second, B. subtilis should not be considered merely as laboratory contaminant especially when cultivated by appropriate central nervous system specimen. 展开更多
关键词 Bacillus SUBTILIS brain abscess Central nervous system infection CRANIOTOMY MENINGITIS Case report
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Potential otogenic complications caused by cholesteatoma of the contralateral ear in patients with otogenic abscess secondary to middle ear cholesteatoma of one ear:A case report 被引量:1
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作者 Li Zhang Xun Niu +2 位作者 Kun Zhang Ting He Yu Sun 《World Journal of Clinical Cases》 SCIE 2022年第28期10220-10226,共7页
BACKGROUND Otogenic brain abscess caused by middle ear cholesteatoma is a potentially serious and life-threatening complication in the ear,nose,and throat clinic.The mortality rate associated with otogenic brain absce... BACKGROUND Otogenic brain abscess caused by middle ear cholesteatoma is a potentially serious and life-threatening complication in the ear,nose,and throat clinic.The mortality rate associated with otogenic brain abscesses is 8%–26.3%.Recently,in China,the incidence of brain abscess secondary to middle ear cholesteatoma has started to increase due to antibiotic resistance.CASE SUMMARY A 55-year-old male presented hearing loss in the right ear and headache for 1 mo in 2018.Computed tomography(CT) showed an area of low density in the right middle ear and mastoid and auditory ossicle defects and a small amount of soft tissue density in the left middle ear.The parietal wall of the right tympanic cavity and the posterior wall of the mastoid sinus were thin and less continuous.Cranial magnetic resonance imaging revealed an area of low intensity encapsulated by an area of high intensity in the right temporal lobe.We diagnosed him with a brain abscess secondary to middle ear cholesteatoma.He received surgery to drain the abscess followed by a modified radical mastoidectomy.The patient visited our department 3 years later because of intermittent otorrhea in the left ear.CT revealed that the area of the soft tissue density in the left middle ear and mastoid was significantly increased.The posterior wall of the mastoid sinus was destroyed,leaving the left middle ear connecting with the brain.The patient underwent a modified radical mastoidectomy in the left ear CONCLUSION Regular follow-up and timely treatment of contralateral ear disease are vital for the prevention of otogenic complications in patients with otogenic abscesses secondary to middle ear cholesteatoma in the unilateral ear. 展开更多
关键词 Middle ear cholesteatoma Otogenic complications brain abscess Case report
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Intracranial Abscesses: An Institutional Study 被引量:1
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作者 Yogendra Singh Tarun Kumar Gupta +1 位作者 Gaurav Jaiswal Krishna Lodha 《Open Journal of Modern Neurosurgery》 2020年第2期297-306,共10页
Background: Brain abscess is defined as a focal intracranial infection that is initiated as an area of cerebritis and evolves into a collection of pus surrounded by a vascularized capsule. These are complications of h... Background: Brain abscess is defined as a focal intracranial infection that is initiated as an area of cerebritis and evolves into a collection of pus surrounded by a vascularized capsule. These are complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Management involves both medical and surgical treatment. Surgical management includes either aspiration or excision of lesions larger than 2.5 cm in diameter, depending on brain location. However, literature on surgical treatment is replete with several procedures which, on their own, may not determine outcome. Aim: Aim is to study the epidemiology, management and outcome of various treatment modalities of brain abscess in our institute. Material and Methods: We conducted a retrospective study of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses in patients admitted to our Neuro-intensive care unit at R.N.T. Medical College, Udaipur, Rajasthan, India from January 2013 to June 2019. Results: We carried out 53 procedures in 43 (30 male and 13 female) patients with various intracranial abscesses. Most abscesses [16, i.e. 37%] occurred in the second decade and second most common in the first decade [15, i.e. 34%]. In infants 4 (9%) cases of intracranial abscesses were present. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (15) or posttraumatic (8). Most commonly abscesses were located in frontal 13 (30%) followed by cerebellar 9 (21%). Burr hole evacuation was done in 74% of cases. 3 patients (7% of cases) died. Prognosis appears to worsen with ventriculitis, multiple abscesses especially in infants, and immunosuppression. Conclusion: In conclusion, brain abscess still continues to be a formidable challenge, with prognosis that dramatically improved over the last decades due to advances in brain imaging, neurosurgical techniques and better use of old and more recent antibacterial agents. Mortality is improved compared with historical series;however, long-term morbidity is significant particularly in the infant population. Further researches must be conducted to clarify specific aspects, such as anticonvulsant prophylaxis/therapy, and also for the improvement of microbiological diagnosis. 展开更多
关键词 brain abscess ASPIRATION Cerebritis
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Abscess in the Splenium of the Corpus Callosum Treated with Direct Drainage via an Occipital Interhemispheric Approach
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作者 Yasushi Motoyama Hisashi Kawai +3 位作者 Yohei Kogeichi Pritam Gurung Young-Soo Park Hiroyuki Nakase 《Open Journal of Modern Neurosurgery》 2015年第1期34-40,共7页
Lesions in the corpus callosum typically represent malignant tumors such as glioblastoma or lymphoma, because of its compact structure comprising tightly packed white-matter tracts. Brain abscess is rarely seen in the... Lesions in the corpus callosum typically represent malignant tumors such as glioblastoma or lymphoma, because of its compact structure comprising tightly packed white-matter tracts. Brain abscess is rarely seen in the corpus callosum. To the best of our knowledge, solitary bacterial abscess confined to the splenium of the corpus callosum has not been reported previously. We report the case of a 72-year-old woman with rapidly progressing disturbance of consciousness following 1 week of antibiotic treatment for bacterial meningitis. Magnetic resonance imaging demonstrated a ring-enhancing round mass located in the splenium of the corpus callosum on gadolinium-enhanced T1-weighted imaging, also showing a bright signal on diffusion-weighted imaging. The patient underwent occipital craniotomy and direct drainage of the lesion in the splenium through the interhemispheric fissure and achieved complete recovery. Brain abscess should be considered among the differential diagnoses for lesions in the splenium of the corpus callosum. An occipital interhemispheric approach to the splenium might be an important option in cases of brain abscess. 展开更多
关键词 brain abscess Splenium of CORPUS Callosum Microsurgical Drainage
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皮疽诺卡菌致多发脑脓肿1例并文献复习 被引量:1
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作者 王丽丽 马序竹 +1 位作者 王小辉 林明贵 《中国感染与化疗杂志》 CAS CSCD 北大核心 2024年第1期32-35,共4页
目的 分析皮疽诺卡菌累及中枢神经系统的临床特征、诊断及治疗,以期提高对该疾病的认识,精准抗感染治疗。方法 报告清华大学附属北京清华长庚医院感染性疾病科收治的1 例皮疽诺卡菌感染致多发脑脓肿的病例,并以“Nocardiafarcinica”为... 目的 分析皮疽诺卡菌累及中枢神经系统的临床特征、诊断及治疗,以期提高对该疾病的认识,精准抗感染治疗。方法 报告清华大学附属北京清华长庚医院感染性疾病科收治的1 例皮疽诺卡菌感染致多发脑脓肿的病例,并以“Nocardiafarcinica”为关键词检索PubMed 1967年1月1日-2022年9月18日的英文文献共433篇,分别以“皮疽奴卡菌”“ 皮疽诺卡菌”“鼻疽奴卡菌”“ 鼻疽诺卡菌”为关键词在万方数据库、维普数据库检索 1999 年 10 月 1 日-2022 年 9 月 18 日的中文文献,共153 篇,收集并分析总结70 例皮疽诺卡菌中枢神经系统感染的病例资料。结果 该院这例患者以“头痛伴意识障碍”入院,入院后脑脊液宏基因组二代测序(mNGS)提示为皮疽诺卡菌,以复方磺胺甲唑为主联合美罗培南、莫西沙星、阿米卡星为治疗方案,治疗1 个月病灶吸收,院外口服复方磺胺甲唑、莫西沙星,总疗程为1 年。文献70 例皮疽诺卡菌中枢神经系统感染患者男性51 例,占72.8%,平均年龄(58.6±15.3)岁,57.1% 患者有糖皮质激素使用史,57.1% 患者同时合并其他脏器播散,80.0%(56 例)的患者通过传统细菌培养明确病原学诊断,其余通过聚合酶链反应或mNGS 诊断。抗感染用药以复方磺胺甲唑为主(85.7%),死亡率24.2%。结论 皮疽诺卡菌中枢神经系统感染,以发热、肢体活动障碍、头痛为主要临床表现,除中枢神经系统受累外,易全身播散,且有较高的死亡率。该病临床表现缺乏特异性,诊断及治疗相对困难,病死率较高,包括mNGS 在内的多种检测手段可协助尽早明确病原学诊断。 展开更多
关键词 诺卡菌病 皮疽诺卡菌 中枢神经系统感染 脑脓肿 宏基因组二代测序
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脑脓肿诊疗现状及研究进展 被引量:1
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作者 陈立泽 张秋实 +1 位作者 李仕铎 佟静 《临床神经外科杂志》 2024年第3期332-336,共5页
脑脓肿(BA)是一种中枢神经系统化脓性感染性疾病,可在脑实质中形成一个包膜包裹的脓腔。BA进展快、预后差的特点使其临床诊疗具有巨大挑战性。对于BA的诊疗形成了一定的共识,同时无论是新致病菌的发现、新诊断技术的推出、该疾病预后的... 脑脓肿(BA)是一种中枢神经系统化脓性感染性疾病,可在脑实质中形成一个包膜包裹的脓腔。BA进展快、预后差的特点使其临床诊疗具有巨大挑战性。对于BA的诊疗形成了一定的共识,同时无论是新致病菌的发现、新诊断技术的推出、该疾病预后的新发现,还是仍在探究的许多争议,如糖皮质激素的使用及其治疗效果的影响、手术方式的选择等均代表着该疾病研究领域的蓬勃发展。本文针对BA的诊疗现状及其研究进展进行综述,以期为BA的临床诊疗提供参考。 展开更多
关键词 脑脓肿 诊断 治疗 预后
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洛菲氏不动杆菌感染性多发鼻窦炎导致鼻窦沟通脑脓肿1例
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作者 王邦向 秦德芳 +2 位作者 霍泳林 张泽舜 马丁 《中国临床神经外科杂志》 2024年第4期254-256,共3页
脑脓肿多因邻近组织感染扩散导致。洛菲氏不动杆菌是一种需氧的革兰氏阴性杆菌,定植于口咽部、皮肤、会阴部等,为一种机会性致病菌,在人体免疫力低下时引起免疫系统受损并导致感染。洛菲氏不动杆菌导致鼻窦沟通脑脓肿临床罕见。本文报道... 脑脓肿多因邻近组织感染扩散导致。洛菲氏不动杆菌是一种需氧的革兰氏阴性杆菌,定植于口咽部、皮肤、会阴部等,为一种机会性致病菌,在人体免疫力低下时引起免疫系统受损并导致感染。洛菲氏不动杆菌导致鼻窦沟通脑脓肿临床罕见。本文报道1例洛菲氏不动杆菌感染性多发鼻窦炎继发导致鼻窦沟通脑脓肿,24岁男性,因突发头痛半个月入院,入院血常规、血清CRP和降钙素原未见异常;脑脊液常规、生化、细菌及真菌培养未见异常;头颅CT、MRI检查考虑左侧额叶多发脓肿,左侧上颌窦和右侧蝶窦囊肿;脑脊液病原微生物检测DNA、RNA检测显示洛菲不动杆菌。给予万古霉素、美罗培南、奥硝唑治疗1周后,复查头颅CT示颅内低密度灶减少。完善术前准备后,行经鼻内镜下左侧鼻窦病损切除+左侧上颌窦、筛窦、额窦切开术。术后1个月复查头部CT及增强MRI示左额叶多发脑脓肿吸收、减少。术后3个月电话随访头痛明显好转。这提示临床上怀疑脑脓肿时,可行CT及MRI检查,以明确诊断,并经验性给予抗生素治疗。当培养不能发现病原菌时,可行基因检测增加检出率。 展开更多
关键词 脑脓肿 鼻窦沟通脑脓肿 洛菲氏不动杆菌 基因检测
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