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Brain abscess complicating cerebral infarct
Yichayaou Beloosesky1, Jonathan Y Streifler, Nachman Eynan
1Department of Geriatrics, Rabin Medical Center, Golda Campus, Sackler School of Medicine, Tel Aviv University, Petach Tikva 49372, Israel. belo-7@zahan.net.il
Presentation:
We report a case of a 68-year-old man who suffered ischemic strokes in the left middle cerebral artery territory and three months later, following urosepsis, developed a cerebral abscess in the infarcted area.
Discussion:
A literature search found only eight other cases. We discuss herein the common clinical aspects of brain abscess complicating strokes, the co-existent diseases, and point out the possibility of underreporting this rare but treatable complication.
Conclusion:
Cerebral abscess should be suspected in patients with a previous brain infarction or haemorrhage, who develop bacteremia and impaired consciousness without a clear explanation to their condition. Advanced age, and medical conditions known adversely to affect immunological competence reinforce the clinical suspicion.
Insights
Brain abscesses can rarely develop in stroke-affected areas, particularly in older patients with compromised immunity. Early suspicion is key for this treatable complication.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Stroke, particularly ischemic stroke, can predispose patients to secondary complications.
- Brain abscesses are serious infections that require prompt diagnosis and treatment.
Observation:
- A case is presented of a 68-year-old man who developed a cerebral abscess in the area of a previous ischemic stroke.
- This complication occurred three months after the initial stroke, following an episode of urosepsis.
Findings:
- A literature review identified only eight previously reported cases of brain abscess complicating stroke.
- The clinical presentation, associated conditions, and potential for underreporting of this rare complication are discussed.
Implications:
- Cerebral abscess should be considered in patients with prior cerebrovascular events who present with unexplained bacteremia and altered mental status.
- Factors such as advanced age and conditions impairing immune function increase suspicion for this treatable complication.
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