Muddassir Rabia, Khalil Asfandyar, Singh Romil, Taj Shafaq, Khalid Zoha
Internal Medicine, Security Forces Hospital, Makkah, SAU.
Internal Medicine, Health Department Khyber Pahktunkhwa, Peshawar, PAK.
Cureus. 2020 Dec 27;12(12):e12326. doi: 10.7759/cureus.12326.
An intracranial abscess caused by is rarely reported in adults. A 17-year-old girl presented with generalized tonic-clonic seizure, high-grade fever, headache, and vomiting with a history of slowly progressing apathy, clumsiness, and disorientation. She had meningeal signs and altered sensorium with a Glasgow Coma Scale of 10. The laboratory analysis revealed leukocytosis and elevated erythrocyte sedimentation rate. Brain computed tomography (CT) revealed a cystic lesion in the left temporal lobe with perilesional edema and a slight midline shift. She was commenced on empiric ceftriaxone, amikacin, and metronidazole. The non-foul smelling pus was drained through a craniotomy, and pus culture showed . Culture sensitivity revealed extended-spectrum B-lactamase production, and she was commenced on intravenous carbapenem in addition to existing drugs. A repeat CT revealed a significant reduction in abscess size, and improvement in her condition was observed. On her recent follow-up visit, she was doing well.
由[未提及具体病因]引起的颅内脓肿在成人中鲜有报道。一名17岁女孩出现全身强直阵挛性发作、高热、头痛和呕吐，并有逐渐进展的冷漠、笨拙和定向障碍病史。她有脑膜刺激征，意识改变，格拉斯哥昏迷量表评分为10分。实验室分析显示白细胞增多和红细胞沉降率升高。脑部计算机断层扫描（CT）显示左颞叶有一个囊性病变，周围有水肿，中线轻度移位。她开始接受经验性头孢曲松、阿米卡星和甲硝唑治疗。通过开颅手术引流了无恶臭的脓液，脓液培养显示[未提及结果]。培养敏感性显示产超广谱β-内酰胺酶，除现有药物外，她开始静脉注射碳青霉烯类药物。重复CT显示脓肿大小显著缩小，其病情有所改善。在最近的随访中，她情况良好。
