The authors describe a case of tuberculous abscess of the cerebellum that originating probably from pulmonary lesion. The development of such a lesion indicates a persistence of infection and an immunological breakdown which may party have been due to unsatisfactory chemotherapy and protein malnutrition. Tuberculous brain abscess, an encapsulated collection of pus containing viable tubercle bacilli, is quite rare and it is different from tuberculoma in several points. Only five cases of tuberculous abscess have been fully documented and bacteriologically confirmed. The clinical, laboratory, and histopathological findings of those reported cases and the author's have been discussed.
Abscess ; Brain Abscess* ; Brain* ; Cerebellum* ; Drug Therapy ; Malnutrition ; Suppuration ; Tuberculoma

Background: Congenital heart disease is a malformation which the prevalence of 8 \ufffd?among alive infants. If it is not being treated on time, these malformations will develop to severe complication. The most common cause of cerebral abscess is congenital heart disease in infants. Objectives:This study aims to learn about some related factors and close consequence of cerebral abscess in congenital cardiac children. Subjects and method:A retrospective and prospective study was conducted on 37 patients with congenital heart disease were suffered from a cerebral abscess since January 2001 to 31 March 2007. Results:The boys were dominant with sex ratio: 1.85/1. Average age of acquired abscess was 6.8 years, 34/37 (91.9%) patients had curable congenital heart disease, including 33/37 (89.2%) diagnosed of right-left shunt. In comparison with patients whom over 2 years old and did not acquire abscess due to congenital cardiac shunt right-left type, there was no significant difference in hemoglobin, hematocrit, erythrocyte and saturation cutannee 13.5% among 37 patients of study were deaths, 26.5% had neurological sequelae and 8.1% were relapses. The average duration of hospitalization was longer (25.7 days) and the average costs were 4,317,000 Vietnam dong. Conclusion: Cerebral abscess was late complication of congenital heart disease and it was very necessary to treat completely the malformation of congenital heart disease in order to prevent of severe complication.
Heart Defects ; Congenital/ epidemiology ; therapy ; Brain Abscess/ epidemiology

This article reports the treatment of a patient suffering from full-thickness electric burn of skull combined with cerebral contusion and intracranial infection to provide experience in treating such patients. Based on detailed analysis on patient's condition and CT results, several operations of surgery and anti-infection treatment were performed on the patient. The wounds healed 6 weeks after injury. The skull defect was repaired with three-dimensionally reconstructed titanium mesh of computer-aided design two years after wound healing. The treatment of full-thickness electric burn of skull combined with cerebral contusion was quite difficult. The timing and mode of operation were very important. Perioperative prevention and treatment of intracranial infection were essential to save the life of the patient. In the event of intracranial infection, effective systemic use of antibiotics, cerebrospinal fluid drainage, intrathecal injection of drugs, and the application of other comprehensive measures could ensure the success of treatment.
Adult ; Brain Abscess ; microbiology ; therapy ; Brain Injuries ; microbiology ; therapy ; Burns, Electric ; microbiology ; therapy ; Humans ; Infection ; therapy ; Male ; Skull ; injuries

PURPOSE: Infection with Nocardia species is an uncommon yet important cause of morbidity and mortality in renal transplant recipients. METHODS: We experienced 6 cases of nocardiosis among 239 renal transplant recipients maintained on tacrolimus- or cyclosporine-based immunosuppression from May 1999 to February 2001. RESULTS: All the six patients had pulmonary nocardiosis from 36 to 220 (mean 82) days after renal transplantation. Due to a multiplicity of infection sites, cerebral abscess was detected in 2 patients, soft tissue abscess in 2, allograft abscess in 1 and subretinal abscess in 1. Comparing the routine trimethoprim/ sulfamethoxazole (TMP/SMX) prophylaxis after transplantation, 5 out of 6 patients took TMP/SMX for a mean of 1.8 months due to an increased AST/ALT. All the cases required invasive diagnostic procedures such as percutaneous needle aspiration (PC NA) or stereotactic aspiration. In the antimicrobial susceptibility test, isolates were sensitive to TMP/SMX, amikacin and imipenem. In the early stage of infection, we used triple chemotherapy (TMP/SMX, amikacin, imipenem) for cerebral nocardiosis and dual therapy (TMP/SMX, amikacin) for localized pulmonary infection. There were no mortality and all the graft maintained stable function. CONCLUSION: After organ transplantation, pneumonia accompanied with satellite soft tissue infection should be considered as a nocardiosis. Pro- phylactic use of TMP/SMX is crucial for effective prevention of nocardiosis.
Abscess ; Allografts ; Amikacin ; Brain ; Brain Abscess ; Drug Therapy ; Humans ; Imipenem ; Immunosuppression ; Kidney Transplantation* ; Mortality ; Needles ; Nocardia ; Nocardia Infections* ; Organ Transplantation ; Pneumonia ; Soft Tissue Infections ; Sulfamethoxazole ; Transplantation ; Transplants

Brain Abscess ; diagnosis ; etiology ; therapy ; Cerebellar Diseases ; diagnosis ; etiology ; therapy ; Ear Diseases ; complications ; Humans ; Male ; Young Adult

Antitubercular Agents ; therapeutic use ; Brain Abscess ; drug therapy ; Humans ; Steroids ; therapeutic use ; Treatment Failure ; Tuberculoma, Intracranial ; drug therapy

The incidence of otogenic intracranial complication has decreased markedly following the advent of modern chemotherapy. Less is it a disease of children in association with acute otitis media. More often it is seen in the adult after a long history of chronic ear disease, especially cholesteatoma. In the modern literature on lateral sinus thrombosis, meningitis and cerebral abscess are listed as the most common concomitant complications and cerebellar abscess is poorer prognosis than any other complications. Recently we experienced a case of cerebellar abscess after treatment of lateral sinus thrombophlebitis associated with cholesteatoma, and reported this case along with literature survey.
Abscess* ; Adult ; Brain Abscess ; Child ; Cholesteatoma* ; Drug Therapy ; Ear Diseases ; Humans ; Incidence ; Lateral Sinus Thrombosis* ; Literature, Modern ; Meningitis ; Otitis Media ; Prognosis ; Transverse Sinuses*

We report a case of primary central nervous system(CNS) lymphoma in an organ recipient. A 33-years-old man who underwent a renal transplantation 3years previously presented with headache and vomiting. In Brain computed tomography scans and magnetic resonance images showed multiple periventricular cystic rim enhancing masses. Pathologic diagnosis by stereotactic biopsy revealed malignant non-Hodgkins B-cell lymphoma. After pathologic confirmation, methotrexate chemotherapy and whole brain radiation therapy were done. Having experienced such a case, the authors strongly recommend to add primary CNS lymphoma as one of the differential diagnoses to brain abscess, metastatic brain tumor and glioblastoma multiforme in cases of multiple ring enhancing periventricular lesions of immunocompromised patient or organ recipient.
Biopsy ; Brain ; Brain Abscess ; Brain Neoplasms ; Central Nervous System* ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Glioblastoma ; Headache ; Immunocompromised Host ; Kidney Transplantation ; Lymphoma* ; Lymphoma, B-Cell ; Methotrexate ; Vomiting

A 59-year-old patient with a history of hepatocellular carcinoma presented with decreased consciousness and left hemiparesis. A rim-enhanced mass lesion without diffusion restriction was observed in contrast-enhanced MRI including diffusion-weighted imaging. Based on these findings, metastatic brain tumor was suspected. However, brain abscess (BA) was diagnosed after multiple bacterial colonies were observed in aspiration biopsy. Initial conventional antibiotic treatment including vancomycin had failed, so linezolid was used as second-line therapy. As a result, infection signs and clinical symptoms were resolved. We report a case with atypical imaging features and antibiotic susceptibility of a BA in an immunocompromised patient undergoing chemotherapy.
Biopsy, Needle ; Brain Abscess* ; Brain Neoplasms ; Brain* ; Carcinoma, Hepatocellular ; Consciousness ; Diffusion Magnetic Resonance Imaging ; Diffusion* ; Drug Therapy ; Humans ; Immunocompromised Host ; Linezolid* ; Magnetic Resonance Imaging ; Middle Aged ; Paresis ; Vancomycin

A 29-year-old man has been presented with disseminated pulmonary tuberculosis and brain parenchymal tuberculous nodule. The CSF examination showed the features of subacute meningitis consistent with tuberculosis, and chronic granulomatous inflammation with acid-fast bacilli was found on pleural biopsy. He was treated with anti-tuberculous chemotherapy and showed subjective improvement of the symptoms. But rather rapidly progressive weakness of lower extremities and voiding difficulty were newly developed, and the thoracic spinal MRI showed diffuse epidural abscess along the entire thoracic segment. He showed excellent clinical improvement with additive steroid therapy.
Adult ; Biopsy ; Brain ; Drug Therapy ; Epidural Abscess* ; Humans ; Inflammation ; Lower Extremity ; Magnetic Resonance Imaging ; Meningitis ; Tuberculosis* ; Tuberculosis, Pulmonary