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Multiple microabscesses in the central nervous system: a clinicopathologic study.

W W Pendlebury1, D P Perl, D G Munoz

  • 1Department of Pathology, University of Vermont, Burlington 05405.

Journal of Neuropathology and Experimental Neurology
|May 1, 1989
PubMed
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Multiple central nervous system (CNS) microabscesses are a common, often missed, sign of infection in chronically ill patients. Consider CNS microabscesses in the differential diagnosis for encephalopathy in hospitalized patients with sepsis and impaired immunity.

Area of Science:

  • Neuropathology
  • Infectious Diseases
  • Clinical Neurology

Background:

  • A review of 2,107 autopsies with neuropathologic examination was conducted.
  • 92 cases with central nervous system (CNS) infection were identified.
  • 35 of these CNS infections presented as multiple microabscesses.

Observation:

  • The patients were chronically ill with impaired immunity, mean age 56.
  • The lung was the most common primary infection site, often with sepsis.
  • Staphylococcus aureus and Candida albicans were the most frequent causative organisms.

Findings:

  • Patients developed progressive encephalopathy with fluctuating neurological signs and symptoms.
  • Laboratory and neuroradiologic studies were not diagnostic.

Related Experiment Videos

  • Multiple CNS microabscesses were a frequent manifestation of infection.

    • Implications:

    • Multiple microabscesses should be considered in the differential diagnosis of encephalopathy.
    • This is particularly relevant for hospitalized patients with chronic disease, immunosuppression, and sepsis.
    • Early recognition can potentially improve patient outcomes through targeted treatment.