We report a case of an infected pneumatocele in the course of anaerobic pneumonia in an adult. To the best of our knowledge, anaerobic pneumonia complicated by a pneumatocele in an adult has not previously been described. The pneumatocele occurred on the fifth day of hospitalization, and rapidly increased in size, with the development of a subsequent mixed anaerobe infection. A pig-tail catheter was inserted and the pus drained. The bacterial culture from the pus was positive for three anaerobes: Bacteroid species, Peptostreptococcus asaccharolyticus and Fusobacterium species. Intravenous antibiotics and percutaneous catheter drainage resulted in a successful treatment.
Pneumonia, Bacterial/*complications/microbiology ; Pneumocephalus/*complications/microbiology ; Middle Aged ; Male ; Humans ; Gram-Negative Anaerobic Bacteria/isolation & purification

An unusual case of spontaneous cerebrospinal fluid (CSF) rhinorrhea with a pneumocephalus is described in a middle-aged woman who presented with a watery nasal discharge for 1 week and headache, vomiting, and fever for 1 day. The neurological examination revealed meningeal signs and bilateral papilledema. The CSF picture suggested pyogenic meningitis, and computed tomography of the brain revealed pneumocephalus. Diagnostic nasal endoscopy showed outpouching of the dura from the left olfactory cleft with a CSF leak and granular nasal mucosa. The defect was repaired surgically, and a biopsy of that area revealed granulomatous changes suggestive of tuberculosis. The patient recovered completely with standard four-drug antitubercular therapy. To our knowledge spontaneous CSF rhinorrhea with pneumocephalus occurring secondary to nasal tuberculosis has not been previously reported.
Antitubercular Agents/therapeutic use ; Biopsy ; Cerebrospinal Fluid Rhinorrhea/diagnosis/*etiology/therapy ; Endoscopy ; Female ; Humans ; Middle Aged ; Nose Diseases/*complications/diagnosis/microbiology/therapy ; Otorhinolaryngologic Surgical Procedures ; Pneumocephalus/diagnosis/*etiology/therapy ; Tomography, X-Ray Computed ; Treatment Outcome ; Tuberculosis/*complications/diagnosis/microbiology/therapy