scholarly journals A Case of Brain Abscess Caused by Medication-Related Osteonecrosis of the Jaw

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Kenji Yamagata ◽  
Hiroki Nagai ◽  
Osamu Baba ◽  
Fumihiko Uchida ◽  
Naomi Kanno ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Maxillary Sinus ◽  
Brain Abscess ◽  
Prostatic Carcinoma ◽  
Osteonecrosis Of The Jaw ◽  
Ethmoid Sinus ◽  
Successful Outcome ◽  
Antibiotic Regimen ◽  
Brain Abscesses ◽  
The Brain

Reports of brain abscesses caused by medication-related osteonecrosis of the jaw (MRONJ) are very rare. We here present the case of a 76-year-old man with terminal-stage prostatic carcinoma and a brain abscess caused by MRONJ at the maxilla. The patient had been treated with zoledronic acid and denosumab for bone metastasis. For the brain abscess, an antibiotic regimen based on ceftriaxone and metronidazole and a sequestrectomy contributed to a successful outcome. In the case of maxillary MRONJ extending to the maxillary sinus, active resection of the infected bone should be considered to prevent the spread of the infection beyond the maxillary sinus, into the ethmoid sinus, and into the brain.

scholarly journals Cerebral Abscess Potentially of Odontogenic Origin

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Marouene Ben Hadj Hassine ◽  
Lamia Oualha ◽  
Amine Derbel ◽  
Nabiha Douki
Keyword(s):  
Brain Abscess ◽  
Odontogenic Infection ◽  
Successful Outcome ◽  
Antibiotic Regimen ◽  
Abscess Drainage ◽  
Microscopic Identification ◽  
Relative Paucity ◽  
Cerebellar Abscess ◽  
Odontogenic Origin ◽  
Brain Abscesses

Odontogenic origins are rarely implicated in the formation of brain abscesses. The relative paucity of this kind of infection and the difficulty in matching the causative microorganisms of a brain abscess to an odontogenic source can explain the late management of patients. We herein describe a case of a 46-year-old man with a cerebellar abscess that was probably due to an odontogenic infection. The diagnosis supported by imaging and microscopic identification, mini craniectomy for abscess drainage followed by eradication of all potential dental infectious foci, and an antibiotic regimen based on cephalosporins, metronidazole, and vancomycine contributed to a successful outcome.

Brain Abscess and Spinal Epidural Abscess

2019 ◽  
pp. 642-648
Author(s):  
Selby G. Chen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Abscess ◽  
Hospital Admissions ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Early Management ◽  
Brain Abscesses ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Epidural ◽  
The Brain

Two infections of the brain are relatively common. Patients with brain abscess are often critically ill and have a high mortality rate. The reported incidence of brain abscesses ranges from 0.4 to 0.9 per 100,000 people. In contrast, spinal epidural abscess (SEA), an infection of the epidural space, has increased in incidence from approximately 0.2 to 1.2 per 10,000 hospital admissions in the mid-1970s to a currently estimated 2.0 to 12.5 per 10,000 admissions. Both disorders are now more easily detected with magnetic resonance imaging (MRI), and this has improved early management, but clinical recognition is still a challenge for many physicians.

Brain abscess: a cogent clarifier of the confused concept of immunity

2008 ◽  
Vol 24 (6) ◽  
pp. E16 ◽  
Author(s):  
Manu Kothari ◽  
Atul Goel
Keyword(s):  
Brain Tissue ◽  
Brain Abscess ◽  
Clinical Experience ◽  
Host Tissue ◽  
Abscess Formation ◽  
Microbial Interaction ◽  
Experimental Inoculation ◽  
Brain Abscesses ◽  
The Brain

✓ The brain tends to be immune to inflammation and abscess formation, despite chronically and recurrently infected neighboring structures, and not uncommon pyemias and septicemias. Experimental inoculation of the brain tissue with microbes confirms this clinical experience. When brain–microbial interaction overcomes immunity, reactivity sets in, resulting in inflammation and abscess formation. Brain abscesses tend to stand apart from the host tissue so as to allow easy aspiration and/or ablation. A brain abscess is a dire neurosurgical emergency. The saving grace is that a few quick steps yield excellent results.

Brain Abscess

2016 ◽  
Author(s):  
Sneha A. Chinai
Keyword(s):  
Brain Abscess ◽  
Signs And Symptoms ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Source Of Infection ◽  
Empiric Antibiotic ◽  
Life Threatening ◽  
Brain Abscesses ◽  
The Brain ◽  
Repeat Imaging

A brain abscess is a life-threatening infection within the brain that originates as cerebritis and evolves into an encapsulated collection of purulent material. Epidemiologically, brain abscesses are seen more frequently in immunocompromised patients. The signs and symptoms of a brain abscess are influenced by the location and size of the infection, the causative pathogen, and the patient’s immune status and medical comorbidities. This diagnosis requires neurosurgical consultation for management and inpatient admission. The majority of patients undergo either needle aspiration or surgical excision. This is critical for obtaining a specimen for culture in order to direct accurate and specific antimicrobial therapy. Needle aspiration is more commonly utilized and has a lower mortality rate than surgical excision. Repeat imaging is required for any change in mental status. Empiric antibiotic selections are guided by the most likely source of infection and are adjusted for renal function.

scholarly journals Diminished Virulence of an Alpha-Toxin Mutant ofStaphylococcus aureus in Experimental Brain Abscesses

2001 ◽  
Vol 69 (11) ◽  
pp. 6902-6911 ◽  
Author(s):  
Tammy Kielian ◽  
Ambrose Cheung ◽  
William F. Hickey
Keyword(s):  
Brain Abscess ◽  
Proinflammatory Cytokine ◽  
Double Mutant ◽  
Virulence Determinants ◽  
Alpha Toxin ◽  
Virulence Determinant ◽  
Chemokine Expression ◽  
Brain Abscesses ◽  
The Brain

ABSTRACT Staphylococcus aureus is one of the major etiologic agents of brain abscesses in humans, occasionally leading to focal neurological deficits and even death. The objective of the present study was to identify key virulence determinants contributing to the pathogenesis of S. aureus in the brain using a murine brain abscess model. The importance of virulence factor production in disease development was demonstrated by the inability of heat-inactivated S. aureus to induce proinflammatory cytokine or chemokine expression or brain abscess formation in vivo. To directly address the contribution of virulence determinants in brain abscess development, the abilities of S. aureus strains with mutations in the global regulatory loci sarA andagr were examined. An S. aureus sarA agr double mutant exhibited reduced virulence in vivo, as demonstrated by attenuated proinflammatory cytokine and chemokine expression and bacterial replication. Subsequent studies focused on the expression of factors that are altered in thesarA agr double mutant. Evaluation of an alpha-toxin mutant revealed a phenotype similar to that of the sarA agr mutant in vivo, as evidenced by lower bacterial burdens and attenuation of cytokine and chemokine expression in the brain. This suggested that alpha-toxin is a central virulence determinant in brain abscess development. Another virulence mechanism utilized by staphylococci is intracellular survival. Cells recovered from brain abscesses were shown to harbor S. aureusintracellularly, providing a means by which the organism may establish chronic infections in the brain. Together, these data identify alpha-toxin as a key virulence determinant for the survival ofS. aureus in the brain.

scholarly journals Prevotella brain abscess in a healthy patient with a patent foramen ovale: Case report

2021 ◽  
Vol 12 ◽  
pp. 548
Author(s):  
Yu Akimoto ◽  
Kiyoyuki Yanaka ◽  
Kuniyuki Onuma ◽  
Kazuhiro Nakamura ◽  
Eiichi Ishikawa
Keyword(s):  
Brain Abscess ◽  
Patent Foramen Ovale ◽  
Foramen Ovale ◽  
Brain Infection ◽  
Source Of Infection ◽  
Venous Shunt ◽  
Life Threatening ◽  
Brain Abscesses ◽  
The Right ◽  
The Brain

Background: Brain abscesses are relatively rare life-threatening infectious lesions often concomitant with a direct spillover of inflammation in the head or neck, hematogenous infections, and immunocompromised conditions. They rarely occur in adults without such predisposing factors. Prevotella is a well-known dental pathogen that very rarely causes brain abscesses. Case Description: We report such an abscess in a 51-year-old man who was innately healthy and had no oral lesions. A comprehensive computed tomography examination of the chest, abdomen, and pelvis, was inconclusive but a transesophageal echocardiogram bubble study revealed a mild patent foramen ovale (PFO) that matched Grade 1 criteria. We deduced that the right-left shunt due to the PFO could have contributed to the brain infection and treated the patient successfully via surgical abscess aspiration and antibiotics. Conclusion: In case of a brain abscess occurring in healthy adults, it is essential to investigate the source of infection and the existence of an arterio-venous shunt, such as PFO.

scholarly journals Brain Abscess Associated with Polymicrobial Infection after Intraoral Laceration: A Pediatric Case Report

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fumihiro Ochi ◽  
Hisamichi Tauchi ◽  
Toyohisa Miyata ◽  
Tomozo Moritani ◽  
Toshiyuki Chisaka ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Fusobacterium Nucleatum ◽  
Brain Parenchyma ◽  
Pediatric Case ◽  
Parvimonas Micra ◽  
Increased Risk ◽  
Brain Abscesses ◽  
Congenital Cyanotic Heart Disease ◽  
The Brain

Brain abscesses, infections within the brain parenchyma, can arise as complications of various conditions including infections, trauma, and surgery. However, brain abscesses due to polymicrobial organisms have rarely been reported in children. We herein report a case of a 9-year-old girl with unresolved congenital cyanotic heart disease (CCHD) presenting with right hemiplegia who was diagnosed with brain abscess caused by Streptococcus intermedius, Parvimonas micra, and Fusobacterium nucleatum after oropharyngeal injury. She was treated with intravenous antimicrobial therapy, drainage under craniotomy, and antiedema therapy with glycerol and goreisan, which led to the improvement of right hemiplegia to baseline; she was discharged following eight weeks of intravenous antimicrobial therapy. The clinical diagnosis of the brain abscess was difficult due to the nonspecific presentation, highlighting the importance of cranial imaging without haste in patients at increased risk for brain abscesses such as those with CCHD, presenting with fever in the absence of localizing symptoms or fever, accompanied with abnormal neurological findings.

scholarly journals Nocardia farcinica Brain Abscess in a Multiple Myeloma Patient Treated with Proteasome Inhibitor: A Case Report and Review of the Literature

2021 ◽  
Vol 11 (9) ◽  
pp. 1204
Author(s):  
Nengwen Xu ◽  
Linjie Li ◽  
Wen Lei ◽  
Wenbin Qian
Keyword(s):  
Multiple Myeloma ◽  
Brain Abscess ◽  
Proteasome Inhibitor ◽  
Brain Mri ◽  
Myeloma Patient ◽  
Multiple Myeloma Patient ◽  
Nocardia Farcinica ◽  
Intracranial Lesions ◽  
Brain Abscesses ◽  
The Brain

Nocardia brain abscess is relatively rare, accounting for about 1–2% of all brain abscesses, and its mortality rate is three times higher than of other types of bacterial brain abscesses; thus, early diagnosis and treatment are essential. Nocardia brain abscess generally occurs in immunodeficient patients. We report a case of Nocardia farcinica brain abscess in a multiple myeloma patient treated with proteasome inhibitor (bortezomib and ixazomib), cyclophosphamide, and corticosteroid. The patient was treated with ceftriaxone and trimethoprim-sulfamethoxazole, together with drainage of the brain abscess. Regular brain MRI follow-ups showed that intracranial lesions were gradually absorbed and improved.

scholarly journals Brain Abscess Caused by Nocardia: Case Report and Literature Review

2020 ◽  
Author(s):  
Guilherme Finger ◽  
Maria Eduarda Conte Gripa ◽  
Tiago Paczko Bozko Cecchini ◽  
Tobias Ludwig do Nascimento
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Clinical Signs ◽  
Occipital Lobe ◽  
High Morbidity ◽  
Rare Clinical Entity ◽  
Brain Abscesses

AbstractNocardia brain abscess is a rare clinical entity, accounting for 2% of all brain abscesses, associated with high morbidity and a mortality rate 3 times higher than brain abscesses caused by other bacteria. Proper investigation and treatment, characterized by a long-term antibiotic therapy, play an important role on the outcome of the patient. The authors describe a case of a patient without neurological comorbidities who developed clinical signs of right occipital lobe impairment and seizures, whose investigation demonstrated brain abscess caused by Nocardia spp. The patient was treated surgically followed by antibiotic therapy with a great outcome after 1 year of follow-up.

scholarly journals Associated characteristics and treatment outcomes of medication-related osteonecrosis of the jaw in patients receiving denosumab or zoledronic acid for bone metastases

2021 ◽  
Author(s):  
Hiroaki Ikesue ◽  
Moe Mouri ◽  
Hideaki Tomita ◽  
Masaki Hirabatake ◽  
Mai Ikemura ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Bone Metastases ◽  
Tooth Extraction ◽  
Proportional Hazards ◽  
Osteonecrosis Of The Jaw ◽  
Cox Proportional Hazards ◽  
Patients With Cancer ◽  
Proportional Hazards Regression ◽  
Before And After ◽  
Denosumab Treatment

Abstract Purpose This study aimed to evaluate the association between clinical characteristics and development of medication-related osteonecrosis of the jaw (MRONJ) in patients who underwent dental examinations before the initiation of treatment with denosumab or zoledronic acid, which are bone-modifying agents (BMAs), for bone metastases. Additionally, the clinical outcomes of patients who developed MRONJ were evaluated along with the time to resolution of MRONJ. Methods The medical charts of patients with cancer who received denosumab or zoledronic acid for bone metastases between January 2012 and September 2016 were retrospectively reviewed. Patients were excluded if they did not undergo a dental examination at baseline. Results Among the 374 included patients, 34 (9.1%) developed MRONJ. The incidence of MRONJ was significantly higher in the denosumab group than in the zoledronic acid (27/215 [12.6%] vs 7/159 [4.4%], P = 0.006) group. Multivariate Cox proportional hazards regression analysis revealed that denosumab treatment, older age, and tooth extraction before and after starting BMA treatments were significantly associated with developing MRONJ. The time to resolution of MRONJ was significantly shorter for patients who received denosumab (median 26.8 months) than for those who received zoledronic acid (median not reached; P = 0.024). Conclusion The results of this study suggest that treatment with denosumab, age > 65 years, and tooth extraction before and after starting BMA treatments are significantly associated with developing MRONJ in patients undergoing treatment for bone metastases. However, MRONJ caused by denosumab resolves faster than that caused by zoledronic acid.

Sign in / Sign up

Export Citation Format

Share Document