Multiple brain abscesses - a rare complication of bronchiectasis

Area of Science:

• Neurology
• Infectious Diseases
• Pulmonology

Background:

• Brain abscesses can result from various infections, trauma, or surgery.
• Bacterial invasion of the brain occurs via direct spread or hematogenous seeding.
• Brain abscesses are an infrequent complication associated with bronchiectasis.

Observation:

• A 44-year-old woman with a history of childhood pulmonary tuberculosis and extensive bilateral bronchiectasis presented with behavioral changes and sixth cranial nerve paresis.
• Multiple brain abscesses were diagnosed; however, microbiological examinations were negative.
• The identified primary infection focus was infected bronchiectasis.

Findings:

• The patient received empirical antibiotics and anti-edematous treatment, showing initial improvement.
• Due to an inadequate response to conservative management, surgical intervention was performed.
• The patient was discharged with persistent diplopia but no other neurological deficits.

Implications:

• Infected bronchiectasis was the sole identified infection source in this case.
• Clinicians should consider and exclude central nervous system infections in patients with bronchiectasis presenting with new neurological manifestations.
• Early recognition and appropriate management are crucial for improving outcomes in brain abscess cases secondary to bronchiectasis.