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Khokhar TI, Qadri HM, Fatima I, Ghafoor A, Bilal MT. Multiple primary brain abscesses in a 14 years old immunocompetent boy: A tale of Proteus mirabilis infestation from Pakistan. Pak J Med Sci 2024; 40:S87-S89. [PMID: 39703963 PMCID: PMC11654649 DOI: 10.12669/pjms.40.12(pins).11033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 08/29/2024] [Accepted: 09/25/2024] [Indexed: 12/21/2024] Open
Abstract
Brain abscess (BA) formation that may be due to due to Gram-positive bacteria commonly and less commonly due Gram-negative bacteria affects pediatric population. Most cases are secondary to the involvement of ear, nose, throat and sinuses (ENTS). We describe a rare case of a 14 year old patient presenting with generalized tonic clonic seizures for the last six months associated with fever, vomiting and headache. ENTS examination was normal. Neuroimaging was suggestive of multiple left fronto-pariettal space occupying lesions. Modified pterional craniotomy was done to excise the multiloculated, encapsulated lesion with yellow-green pus. Culture sensitivity yielded Proteus mirabilis. Patient was discharged from the hospital uneventfully. The diagnosis of multiple primary brain abscesses secondary to Proteus mirabilis is very rare and it should be considered in the list of differentials of multiple brain abscesses when the systematic examination is normal. Early surgical excision is the key to a successful outcome.
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Affiliation(s)
- Tariq Imran Khokhar
- Tariq Imran Khokhar, Associate Professor, Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan
| | - Haseeb Mehmood Qadri
- Haseeb Mehmood Qadri, Post Graduate Resident, Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan
| | - Ibreeza Fatima
- Ibreeza Fatima, Post Graduate Resident, Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan
| | - Abdul Ghafoor
- Abdul Ghafoor, Senior Registrar, Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan
| | - Muhammad Talha Bilal
- Muhammad Talha Bilal, Post Graduate Resident, Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan
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Brenner DA, Valdivia DJ, Ginalis EE, Dadario NB, Mashiach E, Gupta G, Sundararajan S, Nourollah-Zadeh E, Lazar E, Roychowdhury S, Sun H. Brain abscesses following carotid blowout syndrome: a case report. Radiol Case Rep 2024; 19:1319-1324. [PMID: 38292792 PMCID: PMC10825556 DOI: 10.1016/j.radcr.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/03/2023] [Accepted: 12/09/2023] [Indexed: 02/01/2024] Open
Abstract
We report a case of intracranial abscesses development in a patient with head and neck cancer after emergent treatment of carotid blowout syndrome with coil embolization. Our patient is a 60-year-old male who presented with hemoptysis and hematemesis, which raised concerns for impending carotid blowout syndrome. Endovascular occlusion was successfully achieved, and the patient was discharged in stable condition. Ten days later, the patient reported headaches and right facial pain, and magnetic resonance imaging revealed multiple intracranial abscesses. Broad-spectrum intravenous antibiotics were administered, leading to a variable response with some abscesses decreasing in size and others increasing. Seven weeks from discharge, the patient had no neurological deficits, and all abscesses had decreased in size.
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Affiliation(s)
- Daniel A. Brenner
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Daniel J. Valdivia
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | | | - Nicholas B. Dadario
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Elad Mashiach
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Gaurav Gupta
- Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Srihari Sundararajan
- Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Emad Nourollah-Zadeh
- Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Eric Lazar
- Department of Radiology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Sudipta Roychowdhury
- Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Hai Sun
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
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