Brain Abscess Following Intracerebral Hemorrhage in a Patient With Pneumonia

Abstract

Brain abscess is a rare but potentially lethal infection of brain parenchyma, requiring prompt surgical intervention and high-dose antibiotic therapy. Brain abscess is a known complication of surgically treated intracerebral hemorrhage (ICH), but it is exceptionally rare that it occurs at the same site of a nonoperated ICH. Such cases may result from hematogenous spread from distant foci (pneumonia, infectious endocarditis) or contiguous sites. Herein, the authors report a case of 75-year-old woman presenting with a brain abscess 6 weeks after a nonoperated ICH. As the patient suffered from pneumonia during the course of ICH, the authors suspected that the brain abscess might originate from the pneumonia via hematogenous spread. The awareness of brain abscess formation at the site of ICH is of great importance for early diagnosis and prompt treatment.

Brain Abscess Complicating a Traumatic Intracerebral Hemorrhagic Contusion

“…Patients usually present with a fever, headache, and other signs of systemic infection (e.g., leukocytosis, elevated inflammatory markers). 1,3- 8 This patient developed a fever after an acute exam decline on the second day of his second hospital admission (16 days post-trauma).…”

“…When it does occur, it is usually the result of spread of either contiguous or distant foci of infection. 1 In retrospect, the patient’s initial CT showed partial opacification of the right mastoid air cells and tympanic cavity (Figure 1C and D). It should be assumed that all trauma patients with opacified mastoid air cells have a temporal bone fracture until proven otherwise.…”

A developing brain abscess as acute stroke mimic: presentation of case and review of literature

“…However, there have been reports of brain abscess as complication of stroke in adults. To date, there are 20 case reports of brain abscess after stroke that were published [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] . All of these are reported in adults.…”

Unexpected brain finding in pre-autopsy postmortem CT

“…3 Three-dimensional PMCT reconstruction of the skull. Note the small osseous defect (dashed circles) in the posterior wall of the left frontal sinus odontogenic, oral infections, endocarditis and pneumonia [8,[14][15][16]. The infection typically spreads via the blood stream from the infectious site to the brain parenchyma by continuous extension or by venous drainage to the cerebral vein system, i.e.…”