Boom W H, Tuazon C U
Rev Infect Dis. 1985 Mar-Apr;7(2):189-99. doi: 10.1093/clinids/7.2.189.
Seven adults with multiple brain abscesses were successfully treated with antibiotic therapy alone at The George Washington University Medical Center, Washington, D.C., during 1976-1981. Fever, meningismus, and focal neurologic signs were common presenting features. No patient presented with coma or obtundation. Etiologic agents were identified in only three cases. Computerized tomographic (CT) scans were valuable in diagnosing and monitoring the response to therapy. Decrease in the size of the lesions was noted two to nine weeks after initiation of antibiotic therapy. In all patients, clinical signs of improvement preceded evidence of resolution of lesions on CT scan. These results indicate that, in carefully selected patients in whom surgical drainage is not feasible because of the anatomic location and/or multiplicity of lesions, a prolonged course of high-dose intravenous antibiotics alone can lead to a successful outcome.
1976年至1981年期间，华盛顿特区乔治·华盛顿大学医学中心有7名患有多发性脑脓肿的成年人仅通过抗生素治疗就成功治愈。发热、颈项强直和局灶性神经体征是常见的临床表现。没有患者出现昏迷或意识迟钝。仅在3例病例中确定了病原体。计算机断层扫描（CT）在诊断和监测治疗反应方面很有价值。在开始抗生素治疗后两到九周，观察到病变大小减小。在所有患者中，临床改善迹象先于CT扫描显示病变消退的证据。这些结果表明，对于因病变的解剖位置和/或多发性而无法进行手术引流的经过精心挑选的患者，仅延长高剂量静脉注射抗生素疗程即可取得成功的治疗效果。
