Tokatli A, Kanra G, Ayhan Z, Koçoğlu T, Seçmeer G, Oran O
Mikrobiyol Bul. 1984 Oct;18(4):208-12.
A 15 year old boy was admitted to hospital with five days history of fever, headache, vomiting and otorrhea. Findings on physical examination included high fever, purulent drainage from right ear, nuchal rigidity, Brudzinski's and Kernig's signs. Laboratory finding was polymorphonuclear leukocytosis. Computerized tomography (CT) of his brain was normal. A lumbar puncture disclosed purulent CSF. Chloramphenicol and Penicillin G were given intravenously as treatment for the meningitis. After five days of this therapy he continued to be febrile and nuchal rigidity, Brudzinski's and Kerning's signs increased. The second CT demonstrated the presence of an abscess in the cerebellum. The abscess was aspirated during mastoidectomy. In the cultures of the aspiration material Bacteroides species and gram positive micrococci grew out. Metronidazole, 500 mg qid per oral, was added to the therapy. During treatment, his condition was evaluated with serial computerized tomography scans of his brain and these studies showed progressive decrease in the size of the lesion. Metronidazole and antibiotics therapies were continued 45 days. The patient made an uneventful recovery.
一名15岁男孩因发热、头痛、呕吐和耳漏5天入院。体格检查发现包括高热、右耳脓性引流、颈部强直、布鲁津斯基征和凯尔尼格征。实验室检查发现多形核白细胞增多。他的脑部计算机断层扫描（CT）正常。腰椎穿刺显示脑脊液脓性。给予氯霉素和青霉素G静脉注射治疗脑膜炎。经过五天的这种治疗，他仍然发热，颈部强直，布鲁津斯基征和凯尔尼格征加重。第二次CT显示小脑有一个脓肿。在乳突切除术中抽出了脓肿。在抽出物培养物中生长出拟杆菌属和革兰氏阳性微球菌。治疗中加用甲硝唑，口服，500毫克，每日四次。在治疗期间，通过对他的脑部进行系列计算机断层扫描来评估他的病情，这些研究显示病变大小逐渐减小。甲硝唑和抗生素治疗持续45天。患者顺利康复。
