Vazquez Guillamet Laia Jimena, Malinis Maricar F, Meyer Jaimie P
Department of Medicine, Yale New Haven Health-Bridgeport Hospital, 267 Grant St., Bridgeport, CT, 06610, USA.
Section of Infectious Diseases, Yale School of Medicine, New Haven, CT USA.
IDCases. 2017 Jul 20;10:26-29. doi: 10.1016/j.idcr.2017.07.007. eCollection 2017.
We describe a case of a 29-year-old man from Pakistan who presented with progressive neurologic symptoms over 1 week and was found to have a right parietal cerebral abscess. Neurosurgical drainage cultures showed growth of , , and . An abscessed molar was identified as the likely port of entry and was extracted. The patient was treated with metronidazole, vancomycin, and doxycycline because of prior anaphylaxis to penicillin. At 6-month follow-up, repeat magnetic resonance imaging showed no signs of residual abscess. Culture-independent identification techniques (e.g., ribosomal sequencing) increasingly identify as a causative agent and significant pathogen in spontaneous brain abscesses. As understanding about prevalence and pathogenesis improves, questions arise about optimal treatment strategy, which we discuss based on a literature review.
我们描述了一例来自巴基斯坦的29岁男性病例,该患者在1周内出现进行性神经症状,经检查发现患有右侧顶叶脑脓肿。神经外科引流培养显示有 、 和 生长。一颗龋齿被确定为可能的感染入口并被拔除。由于患者既往对青霉素过敏,因此接受甲硝唑、万古霉素和强力霉素治疗。在6个月的随访中,重复磁共振成像显示没有残留脓肿的迹象。不依赖培养的鉴定技术(如核糖体测序)越来越多地将 鉴定为自发性脑脓肿的病原体和重要致病原。随着对 患病率和发病机制的认识不断提高,关于最佳治疗策略的问题也随之出现,我们将基于文献综述对此进行讨论。