1/219. brain abscess caused by streptococcus intermedius: two case reports.BACKGROUND: Although streptococcus intermedius has been recognized as an important pathogen for abscess formation outside the central nervous system, the streptococcus milleri group, of which it is a member, has not been recognized as a specific pathogen for brain abscess, often thought to be caused by Streptococcus viridans, which includes other streptococcal species. CASE DESCRIPTION: Two cases of brain abscess in the left frontal lobe caused by S. intermedius, which responded well to antimicrobial treatment combined with needle aspiration, are presented. In the first patient, the predisposing disease was paranasal sinusitis of the frontal and ethmoid sinuses. In the second patient, the source of the pathogen was not detected despite extensive examination. The patients underwent aspiration of pus under ultrasound guidance in the first patient, and via a computed tomography-guided stereotactic procedure in the second patient. They subsequently received appropriate antimicrobial therapy against S. intermedius isolated from the pus culture. Both patients were discharged without any neurological deficits. CONCLUSION: It is important to recognize S. intermedius as a pathogen of brain abscess, and to be aware of its predisposing factors, i.e., mucosal disturbance and liver abscess.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/219. Embolic bacterial aneurysm of the basilar artery: case report.A patient with basilar artery rupture caused by a septic embolus originating from a mitral valve vegetation is reported. The pathogenesis, investigation and management of infected cerebral aneurysms are reviewed.- - - - - - - - - - ranking = 2236.9911669648keywords = aneurysm, cerebral, artery (Clic here for more details about this article) |
3/219. Palinopsia with bacterial brain abscess and noonan syndrome.Though positive visual symptoms can be psychological in nature, or can result from a perceptive or anxious patients recognizing optical principals in the eye itself, this case illustrates how a thorough history is required to delineate those rarer signs which accompany serious macular or neuro-ophthalmic pathology.- - - - - - - - - - ranking = 1.3333333333333keywords = brain (Clic here for more details about this article) |
4/219. Group A streptococcal brain abscess.A 48-y-old woman with an acute Group A streptococcal brain abscess is described. The abscess enlarged rapidly with neurological deterioration and required open drainage and excision. The patient was treated with antibiotics for 6 weeks and recovered completely. Group A streptococcus is a rare cause of brain abscess in the antibiotic era and may require urgent neurosurgical intervention.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
5/219. Mycotic aneurysm presenting as Pancoast's syndrome in an injection drug user.Injection drug users frequently present to emergency departments with fever. A careful history and physical examination with attention to anatomic localization of symptoms and signs are often necessary to unmask unusual underlying medical conditions. We report a case of a woman with recent injection drug use who presented with fever, a palpable neck mass, and Pancoast's syndrome. She had been seen recently at the ED of another hospital and discharged with oral antibiotics for presumed cellulitis. A mycotic aneurysm of the subclavian artery causing Pancoast's syndrome was later diagnosed by using computed tomography and angiography. A high index of suspicion for anatomically localized infective processes should always be maintained with febrile injection drug users.- - - - - - - - - - ranking = 2628.4887852609keywords = aneurysm, mycotic aneurysm, artery (Clic here for more details about this article) |
6/219. Acute onset of chorea and dystonia following a febrile illness in a 1-year-old boy.A 12-month-old boy with acute onset hemichorea and dystonia following a gastroenteritis has abnormal signal intensities of his basal ganglia on brain magnetic resonance imaging (MRI). A rigorous laboratory investigation is successful in diagnosing his rare condition. A discussion of the differential of abnormal basal ganglia on MRI is presented to help illustrate this case.- - - - - - - - - - ranking = 0.33333333333333keywords = brain (Clic here for more details about this article) |
7/219. Successful treatment of brainstem abscess with stereotactic aspiration.BACKGROUND: Brainstem abscess is an uncommon condition associated with a high mortality. We report a case of brainstem abscess in a 51-year-old female with a pulmonary arteriovenous fistula that was cured after appropriate antibiotic therapy following stereotactic aspiration. The value of stereotactic aspiration in the management of brainstem abscess is documented with a review of the relevant literature. CASE REPORT: A 51-year-old female with a pulmonary arteriovenous fistula suffered fever, diplopia and weakness on the right side. Magnetic resonance (MR) imaging of the brain showed a large cystic mass with ring-like enhancement in the brainstem. A diagnosis of brainstem abscess as a complication of pulmonary arteriovenous fistula was made. MR imaging-guided stereotactic exploration was carried out via the suboccipital transcerebellar approach and the pathogen of the brainstem abscess was identified. The brainstem abscess was cured after treatment employing antibiotics to which the pathogen was sensitive. CONCLUSIONS: Stereotactic aspiration is an effective procedure for brainstem abscesses. This procedure is less invasive than open surgery and can be performed even in patients in poor general condition.- - - - - - - - - - ranking = 4keywords = brain (Clic here for more details about this article) |
8/219. Brain abscesses from neglected open head injuries: experience with 17 cases over 20 years.We are reviewing our experience with 17 civilian cases with post-traumatic brain abscesses treated in the era of CT scanning over a period of 20 years. The principal cause for this intracranial complication was the neglected compound depressed fracture. One was a newborn infant with left parietal abscess caused by a vacuum extraction. We have used the following methods of treating the abscesses: single burr hole aspiration in the newborn with an excellent result; repeated aspiration, with debridement of the depressed fracture, in 5 cases (1 death); aspiration with early subsequent excision, via craniotomy, in 7 cases (no death), and primary excision, via craniotomy, in 4 cases (1 death). The early subsequent excision of the abscess, 2 or 3 days after the initial aspiration, has proved in our experience very satisfactory. In cases with bone fragment into the abscess cavity the excision of the abscess is indicated. The cultured pus from the abscess cavity showed mixed flora (streptococci and staphylococci) in 7 cases; staphylococcus aureus in 4; staphylococcus epidermidis in 2, and no growth in 4 cases. Antibiotics play an important role in the treatment of post-traumatic brain abscesses.- - - - - - - - - - ranking = 0.66666666666667keywords = brain (Clic here for more details about this article) |
9/219. Purulent pericarditis due to group B streptococcus and mycotic aneurysm of the ascending aorta: case report.A 61-year-old female, with a history of uterine and cervical cancer treated with radical hysterectomy and 2 years of postoperative chemotherapy, presented to the emergency department with dyspnea on exertion. Computed tomography of the chest revealed a large pericardial effusion and a sacciform aneurysm of the ascending aorta. The patient subsequently underwent emergency pericardiocentesis with drainage of approximately 330 ml of a bloody and turbid effusion. Cultures from the effusion yielded group B streptococcus. multiple organ failure and disseminated intravascular coagulation syndrome occurred in the acute phase, but gradually improved with continuous antibiotic therapy. On the 194th hospital day, in situ reconstruction of the ascending aorta was successfully performed using a synthetic graft. Although rarely reported, both purulent bacterial pericarditis and mycotic aneurysm can be life-threatening.- - - - - - - - - - ranking = 4650.7145425163keywords = aneurysm, mycotic aneurysm (Clic here for more details about this article) |
10/219. arteriovenous fistula secondary to iliac mycotic aneurysm: helical CT findings.We describe the case of a 59-year-old man who presented a mycotic aneurysm of the common right iliac artery due to streptococcus agalactiae and developed an arteriovenous fistula within the inferior vena cava secondary to spontaneous rupture of the aneurysm. The clinical syndrome, helical computed tomographic, and angiographic findings are described and discussed.- - - - - - - - - - ranking = 4650.9171662835keywords = aneurysm, mycotic aneurysm, artery (Clic here for more details about this article) |
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