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Pyogenic meningitis and cerebral abscesses after endoscopic injection sclerotherapy
1Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract:
Infectious complications of endoscopic injection sclerotherapy (EIS) are rare. We report here a case in which pyogenic meningitis and multiple cerebral abscesses developed after a session of EIS. The patient was successfully treated with a combination of parenteral antibiotics and repeated bedside pus aspirations. Prophylactic antibiotics may be considered in such situations for subsequent sessions of EIS.
Insights
Infectious complications from endoscopic injection sclerotherapy (EIS) are uncommon. This case highlights meningitis and brain abscesses after EIS, successfully treated with antibiotics and drainage, suggesting prophylactic antibiotics for future procedures.
Area of Science:
- Neurology
- Infectious Diseases
- Gastroenterology
Background:
- Endoscopic injection sclerotherapy (EIS) is a common procedure for managing conditions like esophageal varices.
- While generally safe, infectious complications following EIS are rare but can be severe.
Observation:
- A patient developed pyogenic meningitis and multiple cerebral abscesses shortly after undergoing EIS.
- The neurological complications were directly linked to the preceding endoscopic procedure.
Findings:
- The patient's condition was successfully managed through a combination of intravenous antibiotics and repeated bedside aspiration of pus.
- Cerebrospinal fluid analysis and neuroimaging confirmed the diagnosis of pyogenic meningitis and cerebral abscesses.
Implications:
- This case underscores the potential for serious infectious complications, including central nervous system infections, after EIS.
- Prophylactic antibiotic administration may be a prudent consideration for patients undergoing subsequent EIS sessions to mitigate infection risk.