Multiple brain abscesses secondary to bronchiectasis. A case of 34 discrete abscesses in one brain

Neurological and Sleep Disturbances in Bronchiectasis

Bronchiectasis unrelated to cystic fibrosis is a chronic lung disease that is increasingly recognised worldwide. While other common chronic lung conditions such as chronic obstructive lung disease have been associated with cardiovascular disease, there is a paucity of data on the relationship between bronchiectasis and cardiovascular risks such as stroke and sleep disturbance. Furthermore, it is unclear whether other neuropsychological aspects are affected, such as cognition, cerebral infection, anxiety and depression. In this review, we aim to highlight neurological and sleep issues in relation to bronchiectasis and their importance to patient care.

Utilization of multidisciplinary surgical techniques to successfully manage 20 brain abscesses in a child

PURPOSE

This study describes a case of multiple brain abscesses in a four-year-old boy who presented with a history of fever and disorientation.

METHODS

Medical investigations revealed severe leukocytosis and the presence of 20 hypodense lesions in the boy's cerebrum. Initial medical treatment included intravenous antibiotics, antiepileptics, and dexamethasone. The boy underwent five surgical interventions within a period of 5 weeks that included frameless stereotactic craniotomies for aspiration and resection of the abscesses.

RESULTS

At the 3-month follow-up, the boy displayed no neurological deficits and no lesions were detected in his brain.

CONCLUSIONS

This study reveals the importance of instituting a standardized protocol to determine the urgency of surgical intervention in cases of brain abscess so that surgical treatment can be applied in the appropriate time period. This case also shows that rewarding results can be obtained in treating brain abscesses in children when the proper treatment method is initiated in the appropriate amount of time.

Multiple brain abscesses - a rare complication of bronchiectasis

BACKGROUND

Brain abscess can arise as a complication of a variety of infections, trauma or surgery. Bacteria can invade the brain by direct spread or through haematogenous seeding. Brain abscesses are described as a rare complication of bronchiectasis.

CASE DESCRIPTION

A 44 -year -old woman with pulmonary tuberculosis in childhood and with the diagnosis of bilateral extensive bronchiectasis who presented behaviour alterations and later, paresis of the sixth cranial nerve, was diagnosed multiple brain abscesses. The microbiological exams were negative. The study of the primary focus of infection could only identify infected bronchiectasis. Empiric antibiotics and anti- -oedematous treatment were prescribed with progressive clinical improvement. Because of inadequate response she was submitted to surgery. She was discharged with diplopia, without any other neurological alterations.

CONCLUSION

In the present clinical case, the infected bronchiectasis were the only focal infection detected, so in patients with this disease and with new neurological manifestations, infected lesions in the central nervous system should be excluded.