Shimogawa Takafumi, Sayama Tetsuro, Haga Sei, Akiyama Tomoaki, Morioka Takato
Department of Neurosurgery, Kyushu Rosai Hospital.
No Shinkei Geka. 2015 Feb;43(2):137-42. doi: 10.11477/mf.1436202969.
We report a rare case of cerebellar abscess produced by anaerobic bacteria. A 76-year-old man was admitted to our hospital with a history of fever, vomiting, and dizziness lasting 14 days. Computed tomography(CT)scan and magnetic resonance images showed the presence of a multiloculated cerebellar abscess with a right subdural abscess. The patient underwent aspiration of the abscess through a suboccipital craniotomy. Fusobacterium nucleatum, which is an anaerobic bacteria naturally present in the human oral cavity, was detected in cultures of the aspirated abscess. The patient was administered antibiotic treatment combined with hyperbaric oxygen therapy(HBO). The symptoms were briefly relieved but the cerebellar abscess recurred, which required a second aspiration. The combined treatment with antibiotics and HBO was maintained after the second operation. After 6 weeks of treatment, the cerebellar abscess was completely controlled. We conclude that antibiotic treatment combined with HBO is useful for treatment of cerebellar abscesses caused by infection with anaerobic bacteria.
我们报告了一例罕见的由厌氧菌引起的小脑脓肿病例。一名76岁男性因发热、呕吐和头晕病史持续14天入住我院。计算机断层扫描(CT)和磁共振成像显示存在多房性小脑脓肿伴右侧硬膜下脓肿。患者通过枕下开颅术进行了脓肿抽吸。在抽吸的脓肿培养物中检测到具核梭杆菌,这是一种自然存在于人体口腔中的厌氧菌。患者接受了抗生素治疗并联合高压氧治疗(HBO)。症状短暂缓解,但小脑脓肿复发,需要再次抽吸。第二次手术后继续维持抗生素和HBO联合治疗。经过6周的治疗,小脑脓肿得到完全控制。我们得出结论,抗生素治疗联合HBO对治疗由厌氧菌感染引起的小脑脓肿是有效的。