Brain Abscess Caused by Enterococcus avium: A Case Report and Review of the Literature

Area of Science:

• Neurology
• Infectious Diseases
• Otolaryngology

Background:

• Brain abscesses are life-threatening infections requiring prompt treatment.
• Enterococcus avium is an uncommon cause of brain abscesses, with few reported cases.
• Chronic otitis media can be a predisposing factor for intracranial infections.

Purpose of the Study:

• To report a rare case of brain abscess caused by Enterococcus avium.
• To discuss the clinical presentation, diagnosis, and management of this rare infection.
• To review the existing literature on Enterococcus avium brain abscesses.

Main Methods:

• Case report of a 48-year-old male with chronic otitis media.
• Clinical evaluation including otoscopy and neurological examination.
• Diagnostic imaging using Brain Magnetic Resonance Imaging (MRI).
• Microbiological culturing of ear discharge and abscess aspirate.
• Stereotactic aspiration of the brain abscess.
• Antimicrobial treatment and literature review.

Main Results:

• The patient presented with headache, otalgia, and purulent ear discharge.
• Brain MRI revealed a hypodense lesion consistent with a brain abscess in the right temporoparietal lobe.
• Cultures confirmed Enterococcus avium as the causative agent in both ear discharge and abscess aspirate.
• Successful treatment achieved through stereotactic aspiration and appropriate antimicrobial therapy.
• Patient experienced a complete recovery.

Conclusions:

• Enterococcus avium can cause severe brain abscesses, even in the absence of typical risk factors.
• Early diagnosis and aggressive management, including surgical drainage and targeted antibiotics, are crucial for favorable outcomes.
• This case underscores the importance of considering rare pathogens in brain abscesses, particularly in patients with otitis media.