AMPJ Journal

Case Report

Cerebral abscess remains a challenging clinical problem with substantial associated morbidity and mortality[1]. Infectious causes can be attributed to bacteria, mycobacteria, fungi, or parasites, and the reported incidence ranges from 0.4 to 0.9 cases per 100,000 population[2,3]. We present the case of an 8-year-old female with history of unrepaired atrial septal defect presented with a two-day history of increased somnolence and emesis on the day of admission. Previously, she had complained of headaches for four to six weeks. In the emergency department, diagnostic work-up including magnetic resonance imaging of the brain showed a 6.7 cm by 4.2 cm ring-enhancing lesion in the left frontal lobe with mass effect and effacement of the third ventricle (Figure). Patient underwent stereotactic-guided aspiration and 66 mL of purulent fluid was drained. Fluid culture grew Streptococcus intermedius. Intravenous antibiotics were administered for four weeks and patient discharged in good condition. Early diagnosis and early implementation of appropriate antimicrobial therapy can improve outcomes for patients with cerebral abscess.

Figure:Axial (Panel A) and coronal (Panel B) T1-weighted magnetic resonance imaging of the brain showed a 6.7 cm by 4.2 cm ring-enhancing lesion in the left frontal lobe with mass effect and effacement of the third ventricle.

1.       Brouwer MC,Tunkel AR,McKhann GM,de Beek DV (2014) Brain Abscess. N Engl J Med 371:447-456.

2.       Nicolosi A, Hauser WA, Musicco M, Kurland LT (1991) Incidence and prognosis of brain abscess in a defined population: Olmsted County, Minnesota 1935-1981. Neuroepidemiology10:122-131.

3.       Helweg-Larsen J, Astradsson A, Richhall H, Erdal J, Laursen A, et al. (2012) Pyogenic brain abscess, a 15-year survey. BMC Infect Dis 12:332-332.