Sommer F, Aldini R, Kolodziejczyk D
Behandlungszentrum Vogtareuth, Department of Neurosurgery, Germany.
Acta Neurochir (Wien). 1998;140(10):1095-6. doi: 10.1007/s007010050221.
A 68-year old patient presented with increasing right-sided weakness, dysarthria, pyrexia and a deteriorating general condition. CT and MRI showed about 20 round hyperdense lesions with peripheral enhancement of contrast material up to 1.5 cm in diameter. Antibiotic triple-therapy using ceftriaxone, gentamycin and metronidazole for 39 days and followed by antibiotic double-therapy using ceftriaxone and metronidazole for a further 22 days resulted in a radiologically proven reduction of the abscesses to very small remnants which disappeared completely during the follow-up period of two years. Simultaneously the general condition of the patient improved significantly. Repeated attempts at isolation of bacteria, fungi, protozoa and parasites from a subdural empyema failed. The histological examination of an abscess, which was entirely removed on occipital craniotomy, showed a structure resembling actinomycosis.
一名68岁患者出现右侧肢体无力加重、构音障碍、发热及全身状况恶化。CT和MRI显示约20个圆形高密度病灶，周围有造影剂强化，直径达1.5厘米。使用头孢曲松、庆大霉素和甲硝唑进行三联抗生素治疗39天，随后使用头孢曲松和甲硝唑进行双联抗生素治疗22天，影像学证实脓肿缩小至非常小的残余灶，并在两年的随访期内完全消失。同时，患者的全身状况明显改善。多次尝试从硬膜下积脓中分离细菌、真菌、原生动物和寄生虫均未成功。经枕部开颅手术完全切除的一个脓肿的组织学检查显示其结构类似放线菌病。
