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Multiple Brain Abscesses Caused by Fusobacterium nucleatum Treated Conservatively

Published online by Cambridge University Press:  02 December 2014

Josef G. Heckmann ,
Christoph J.G. Lang ,
Heinz Hartl  and
Bernd Tomandl
Josef G. Heckmann
Affiliation:
Deptartment of Neurology, University Hospital, Erlangen-Nuremberg, Germany
Christoph J.G. Lang
Affiliation:
Deptartment of Neurology, University Hospital, Erlangen-Nuremberg, Germany
Heinz Hartl
Affiliation:
Deptartment of Neurology, University Hospital, Erlangen-Nuremberg, Germany
Bernd Tomandl
Affiliation:
Neuroradiology, University Hospital, Erlangen-Nuremberg, Germany
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Abstract

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Background:

Multiple brain abscesses are serious neurological problems with high mortality and disabling morbidity. The frequency is rising as a result of AIDS and the increasing number of immunocompromised patients.

Case study:

A 59-year-old woman developed signs and symptoms of diffuse brain dysfunction including fever and neck stiffness. A brain CT scan demonstrated nine contrast-enhancing ring-shaped lesions. Analysis of the cerebrospinal fluid using PCR-technique revealed DNA of Fusobacterium nucleatum. Conservative treatment with antibiotics was successful. The patient recovered with only mild cognitive deficits.

Results:

The experience of our patient and the review of the literature indicate that multiple brain abscesses due to Fusobacterium nucleatum are rare. The most probable source is oral infection.

Conclusion:

Multiple brain abscesses may be caused by Fusobacterium nucleatum. Cerebrospinal fluid analysis using PCR technique is helpful with diagnosis. Conservative management can be successful.

Résumé:

RÉSUMÉ: Introduction:

Les abcès cérébraux multiples constituent toujours un problème neurologique sérieux comportant un taux de mortalité élevé et une morbidité sévère. Leur fréquence augmente dans le contexte de l’épidémie du SIDA et du nombre croissant de patients immunocompromis.

Étude de cas:

Une femme âgée de 59 ans a présenté des signes de dysfonction cérébrale diffuse accompagnés d’hyperthermie et de raideur de la nuque. La tomodensitométrie cérébrale a mis en évidence la présence de neuf lésions annulaires rehaussantes. L’analyse du liquide céphalo-rachidien (LCR) au moyen de la technique de l’amplification en chaîne par polymérase (PCR) a révélé la présence d’ADN du Fusobacterium nucleatum. Le traitement conservateur par antibiotiques a été efficace et la patiente ne présentait comme séquelle que de légers déficits cognitifs.

Résultats:

Ce cas ainsi que la revue de la littérature indiquent que les abcès cérébraux multiples dus au Fusobacterium nucleatum sont rares. La source d’infection la plus probable est une infection orale.

Conclusions:

Des abcès cérébraux multiples peuvent être causés par le Fusobacterium nucleatum. L’analyse du LCR par la technique de la PCR peut aider au diagnostic. Le traitement conservateur peut être efficace.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 30 , Issue 3 , August 2003 , pp. 266 - 268
Copyright
Copyright © The Canadian Journal of Neurological 2003

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