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Cerebral abscesses due to Pseudomonas pseudomallei
V Kasantikul1, S Lerdlum, N Suwanwela
1Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Abstract:
Two cases of cerebral abscesses caused by Pseudomonas pseudomallei are reported. The first case, a 51-year-old women had a sudden onset of progressive right hemiparesis and right facial palsy and died within 7 days. Postmortem examination disclosed brain abscess in association with disseminated infection outside the central nervous system. The second case, a 9-year-old boy displayed cerebral abscesses as an isolated manifestation. Recovery occurred after treatment with ceftazidime. Review of the ten case reports of cerebral melioidosis revealed that the lesion occurred in patients of all ages and was more common in men than in women. The frontoparietal lobe was the most common location. Fever, headache, and hemiparesis were frequent clinical manifestations while seizures, ataxia were uncommon. CT scanning, serum antibody titer along with hemoculture were useful investigate tools. The importance of early diagnosis and prompt treatment is emphasized for this fatal but treatable disease.
Insights
Cerebral melioidosis, caused by Pseudomonas pseudomallei, presents as brain abscesses. Early diagnosis and prompt treatment with antibiotics like ceftazidime are crucial for managing this potentially fatal infection.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Melioidosis is a serious infectious disease caused by the bacterium Pseudomonas pseudomallei.
- Cerebral involvement, or melioidosis, can lead to the formation of brain abscesses.
Observation:
- Two cases of cerebral abscesses due to Pseudomonas pseudomallei are presented.
- One patient, a 51-year-old woman, experienced rapid neurological decline and disseminated infection.
- A 9-year-old boy presented with isolated cerebral abscesses and recovered with ceftazidime treatment.
Findings:
- A review of ten cerebral melioidosis cases showed it affects all ages, predominantly men.
- The frontoparietal lobe was the most common site for abscesses.
- Common symptoms include fever, headache, and hemiparesis; seizures and ataxia are less common.
Implications:
- Computed tomography (CT) scanning, serum antibody titers, and hemoculture are valuable diagnostic tools.
- Early diagnosis and prompt antibiotic treatment are vital for improving outcomes in cerebral melioidosis.
- This condition, though fatal, is treatable with timely medical intervention.