Haemophilus paraphrophilus; a rare cause of intracranial abscess

No increase in headache after previous intracranial infections: a historical cohort study (HUNT)

BACKGROUND AND PURPOSE

Despite the absence of robust scientific evidence, it is today generally accepted that the acute headache typical for intracranial infections can develop into permanent headache complaints. This widespread concept was explored in the first, large, longitudinal, population-based study.

METHODS

Data on confirmed exposure to intracranial infections amongst all adult inhabitants in a geographical area during a 20-year period were assembled from hospital records. Surviving individuals were later invited to the third Nord-Trøndelag Health Survey (HUNT 3), where 39,690 (42%) of 94,194 invited inhabitants aged ≥20 years responded to a validated headache questionnaire. Using logistic regression, the 1-year prevalence of headache and its subtypes according to the diagnostic criteria of the International Headache Society was assessed and compared between those with and without previous confirmed intracranial infection. Age and sex were used as covariates.

RESULTS

Overall, 43 participants were identified with earlier intracranial infection, whereof three had more than one infection: bacterial meningitis (n=19), lymphocytic meningitis (n=18), encephalitis (n=9), and brain abscess (n=1).The mean interval from infection to participation in HUNT 3 was 11.2 (range 1.5-19.7) years. There was no significant increase in the prevalence of headache (OR 1.10, 95% CI 0.58-2.07), its subtypes (migraine, or tension-type headache), or chronic daily headache (OR 1.85, 95% CI 0.45-7.68) amongst participants with previous intracranial infection compared with the surrounding population.

CONCLUSIONS

This study challenges the existence of chronic post-bacterial meningitis headache and does not indicate the presence of other long-term headaches induced by intracranial infection.

Haemophilus paraphrophilus, a rare cause of intracerebral abscess in children

We report on a 3-year-old boy presenting with left-sided eyelid myocloni due to an intracranial abscess harboring Haemophilus paraphrophilus. This is the first description of an intracranial infection with this pathogen in a child.

Successful treatment of pituitary abscess with oral administration of sparfloxacin

Pituitary abscess is a rare infection and it is difficult to make the correct diagnosis. It is usually treated by a combination of surgical drainage and intravenous administration of antibiotics. We describe a 74-year-old woman with recurrent meningo-encephalitis due to pituitary abscess. The abscess increased in size in spite of the intravenous administration of panipenem/betamipron (PAPM/BP), clindamycin (CLDM) and chloramphenicol (CP). Finally she was successfully treated with oral administration of sparfloxacin (SPFX) without operation.

Haemophilus paraphrophilus prosthetic valve endocarditis

We report a case of prosthetic, aortic valve, infective endocarditis caused by Haemophilus paraphrophilus. There are no other cases described in the available literature where this microorganism has caused prosthetic valve endocarditis and no other case reported involving only the aortic valve.