Monteiro Felipe M R, O'Boyle Ryan P, Taylor Ruby R, John Danny L, Piedade Guilherme S, Cordeiro Joacir G
Department of Neurosurgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Medical Scientist Training Program, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Reports (MDPI). 2024 Nov 27;7(4):107. doi: 10.3390/reports7040107.
: A brain abscess, defined as a localized intracranial infection that evolves into a purulent collection encased by a vascularized capsule, has higher prevalence among immunocompromised populations. Patients with sickle cell disease (SCD) are particularly vulnerable to bacterial infections due to their compromised immune systems, increasing their susceptibility to pathogens like . While is typically associated with gastroenteritis, osteomyelitis, and septicemia, its involvement in brain abscesses is exceedingly rare. There are few documented cases of brain abscesses in the general population, and among patients with SCD, only one such case has been reported to date. In this report, we describe the second known case of a brain abscess caused by infection in a patient with sickle cell disease, contributing to the limited literature on this rare and life-threatening condition. : A 32-year-old African American woman with sickle cell disease presented to the ER after a generalized seizure, reporting two weeks of worsening headaches, fevers, and left upper extremity weakness. Imaging revealed a right frontoparietal brain abscess, which was surgically drained, and cultures identified enterica. After antibiotic treatment and a 23-day hospital stay, she was discharged. Four months later, she returned with another seizure during a sickle cell crisis, but follow-up MRI showed only minor scarring, and she was discharged on anticonvulsant therapy. : This case emphasizes that infections, though typically linked to osteomyelitis and sepsis, can also cause brain abscesses in immunocompromised patients like those with sickle cell disease. It highlights the need to consider infections alongside vascular causes in acute neurological cases and underscores the value of a multidisciplinary approach in managing such complex conditions.
脑脓肿被定义为一种局限性颅内感染,会发展成一个被血管化包膜包裹的脓性病灶,在免疫功能低下人群中患病率较高。镰状细胞病(SCD)患者由于免疫系统受损,特别容易受到细菌感染,增加了他们对诸如[病原体名称未给出]等病原体的易感性。虽然[病原体名称未给出]通常与肠胃炎、骨髓炎和败血症有关,但其累及脑脓肿极为罕见。在普通人群中,记录在案的[病原体名称未给出]脑脓肿病例很少,在SCD患者中,迄今为止仅报告了一例。在本报告中,我们描述了镰状细胞病患者中由[病原体名称未给出]感染引起的脑脓肿的第二例已知病例,为关于这种罕见且危及生命状况的有限文献增添了内容。:一名32岁患有镰状细胞病的非裔美国女性在全身癫痫发作后前往急诊室,报告有两周头痛加剧、发热和左上肢无力。影像学检查发现右额顶叶脑脓肿,通过手术进行了引流,培养物鉴定为[病原体名称未给出]肠炎亚种。经过抗生素治疗和23天的住院治疗后,她出院了。四个月后,她在镰状细胞危象期间再次癫痫发作,但后续的MRI检查仅显示轻微瘢痕形成,她在接受抗惊厥治疗后出院。:该病例强调,[病原体名称未给出]感染虽然通常与骨髓炎和败血症有关,但也可在免疫功能低下的患者如镰状细胞病患者中引起脑脓肿。它突出了在急性神经病例中除血管病因外还需考虑感染的必要性,并强调了多学科方法在管理此类复杂病症中的价值。