Van der Cruyssen Frederic, Grisar Koenraad, Maes Honorine, Politis Constantinus
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium.
BMJ Case Rep. 2017 Feb 22;2017:bcr2016218845. doi: 10.1136/bcr-2016-218845.
We report the case of a 65-year-old man presenting with generalised seizures after developing a right frontal brain abscess. Stereotactic aspiration and subsequent matrix assisted laser desorption/ionisation time-of-flight analyzer (MALDI-TOF) spectrometry revealed as the only causative anaerobe microorganism. Secondary incision and drainage was required due to neurological deterioration with increased dimensions of the abscess, intracranial pressure and formation of a subdural occipitoparietal empyema. Oral imaging was positive for apical periodontitis of multiple elements; therefore, the remaining dentition was removed. Targeted antibiotic treatment included intravenous ceftriaxone and ornidazole. The patient was discharged to our revalidation unit 59 days after admission to make a full recovery. To the best of our knowledge, this is the sixth reported case of causing an intracranial abscess and the third case of a true intracerebral parenchymal abscess caused by this bacterium.
我们报告了一例65岁男性病例,该患者在出现右侧额叶脑脓肿后发生全身性癫痫发作。立体定向抽吸及随后的基质辅助激光解吸/电离飞行时间分析仪(MALDI-TOF)光谱分析显示,[具体细菌名称未给出]是唯一的致病性厌氧微生物。由于神经功能恶化,脓肿尺寸增大、颅内压升高以及枕顶硬膜下积脓形成,需要进行二次切开引流。口腔影像学检查显示多个牙尖周炎呈阳性;因此,拔除了剩余牙齿。针对性抗生素治疗包括静脉注射头孢曲松和奥硝唑。患者入院59天后出院至我们的康复单元,实现了完全康复。据我们所知,这是第六例报道的由[具体细菌名称未给出]引起颅内脓肿的病例,也是该细菌引起的第三例真正的脑实质内脓肿病例。