Brain abscess, subdural empyema, and intracranial epidural abscess

Calfee, David P.; Wispelwey, Brian

doi:10.1007/s11908-996-0025-5

Cited by 14 publications

(5 citation statements)

References 65 publications

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“…A brain abscess is a focal, intracerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule (Mathisen & Johnson, 1997). Subdural empyema is focal collection of pus located between the dura mater and the arachnoid mater, while an intracranial epidural abscess involves a pyogenic process and is characterized by accumulation of pus between the skull and the dura mater (Calfee & Wispelwey, 1999).…”

Section: Introductionmentioning

confidence: 99%

Current epidemiology of intracranial abscesses: a prospective 5 year study

Menon

Bharadwaj

Chowdhary

et al. 2008

Journal of Medical Microbiology

112

107

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Intracranial abscesses remain a significant health-care problem in developing countries. In view of this, we undertook a comprehensive study to determine the demographics and bacteriological spectrum of brain abscesses in our hospital. Bacteriological profiles and antibiograms were studied by conventional microbiological methods. Seventy-five patients were admitted with brain abscesses over a 5 year period (2001)(2002)(2003)(2004)(2005). There was 9.5 % mortality in patients included in this study. The most important factors influencing mortality from intracranial abscess were the age and neurological condition of the patient at the time of admission. Brain abscess could develop at any age but there was a preponderance of males over females. Chronic suppurative otitis media was the most common predisposing factor for temporal lobe infections. Forty-one (54.70 %) abscesses were found to be due to pyogenic organisms, 4 % due to Mycobacterium tuberculosis and 1.3 % were due to Cladophialophora bantiana. The majority of microbial isolates were sensitive to the therapeutic regime adopted in our neurosurgery unit (cefotaxime, gentamicin and metronidazole). Chloramphenicol is another antibiotic with in vitro activity against the isolates.

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Section: Introductionmentioning

confidence: 99%

Current epidemiology of intracranial abscesses: a prospective 5 year study

Menon

Bharadwaj

Chowdhary

et al. 2008

Journal of Medical Microbiology

112

107

View full text Add to dashboard Cite

show abstract

“…Intracranial epidural abscess is the third most common focal intracranial infection, apart from the brain abscess and subdural empyema. [4] It takes place in the space between the inner skull table and dura mater. The intracranial dura mater forms the inner lining of the skull and is directly adherent to the bone.…”

Section: Discussionmentioning

confidence: 99%

Infratentorial Epidural Abscess Secondary to Furunculosis: Case Report and a Review of the Literature

Menéndez

Erice

Vázquez

et al. 2019

Journal of Neurosciences in Rural Practice

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The authors describe a case of infratentorial epidural abscess caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in a patient with a recent history of cutaneous furunculosis. This 29-year-old male presented with an occipital headache associated with fever, vomiting, and neck stiffness. Admission magnetic resonance imaging showed a retrocerebellar epidural abscess. Antimicrobial therapy was started, and the patient underwent craniectomy for evacuation of the abscess. Cultures of the surgical specimen were consistent with CA-MRSA. Postoperatively, the patient's condition improved with the resolution of symptoms, and he was discharged home with indication of 6 weeks of antibiotic therapy. Furunculosis is a very rare cause of intracranial epidural abscess but should be considered as a source of infection in an immunocompetent patient.

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“…Patients presenting with focal neurologic symptoms and signs of headache, visual impairment, ophthalmoplegia, or papilledema warrant urgent evaluation. MRI is superior to CT in distinguishing suspected brain abscess, but culture of the specimen is the gold standard for accurate diagnosis [ 9 , 18 ]. The specimen should be sent for Gram’s stain, aerobic, anaerobic, mycobacterial, and fungal cultures including histopathology.…”

Section: Discussionmentioning

confidence: 99%

Intracranial abscess due to Mycobacterium avium complex in an immunocompetent host: a case report

2015

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BackgroundMycobacterium avium complex (MAC) is a ubiquitous pathogen, widely distributed in the environment including water, soil and animals. It is an uncommonly encountered clinical pathogen; primarily causing pulmonary infections in patients with underlying lung disease or disseminated disease in immunocompromised hosts. Sporadically, extra-pulmonary infections have been documented including involvement of the liver, spleen, skin, soft tissue and lymph nodes. Central nervous system (CNS) infections due to MAC are exceedingly rare and carry a poor prognosis. Additionally, such infections are largely reported in patients infected with HIV. Herein we report the first case of intracranial abscess due to MAC in an immunocompetent man with a normal CD4 count and negative HIV status.Case presentationA previously healthy 40-year-old male presented to us with progressively worsening CNS symptoms. The patient’s presentation was uncharacteristic of MAC infection in immunocompetent hosts, as he developed subacute, progressive symptoms that included severe frontal headaches, left eyelid swelling, blurry vision, and diplopia, without any pulmonary or systemic manifestations. Neuroimaging revealed multiple ring-enhancing lesions, which required neurosurgical intervention. MAC was the only pathogen that grew from intraoperative tissue cultures. The patient was subsequently treated with a 12-month regimen consisting of Clarithromycin, Ethambutol, and Rifampin, with successful clinical resolution.ConclusionOur findings indicate that it is important to consider rare infections such as MAC in immunocompetent patients, regardless of atypical symptoms. Despite the severity of this infection, with timely diagnosis effective treatment is available.

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Brain abscess, subdural empyema, and intracranial epidural abscess

Cited by 14 publications

References 65 publications

Current epidemiology of intracranial abscesses: a prospective 5 year study

Current epidemiology of intracranial abscesses: a prospective 5 year study

Infratentorial Epidural Abscess Secondary to Furunculosis: Case Report and a Review of the Literature

Intracranial abscess due to Mycobacterium avium complex in an immunocompetent host: a case report

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