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Rare case of cryptogenic brain abscess caused by Raoultella ornithinolityca
1Marianna Luongo, Department of Neurosurgery, San Carlo Hospital, 85100 Potenza, Italy.
Abstract:
Cerebral abscess is a potentially fatal neurosurgical condition, despite improvements in technology, new antimicrobial agents and modern neurosurgical instruments and techniques. I report the case of a 64-year-old woman, affected by a right frontobasal brain abscess, compressing the homolateral frontal horn of lateral ventricle, with a second mass partially occupying the right orbital cavity. She presented also with inflammatory sinusopathy involving the right maxillary, ethmoid and frontal sinuses. After 14 d of clinical observation and antimicrobial therapy, the patient received a computed tomography scan, which showed growth of the cerebral mass, with a ring of peripheral contrast enhancement and surrounding edema. She promptly underwent neurosurgical treatment and recovered well, except for the sight in her right eye, which remained compromised, as before the operation. This is believed to be the first case of cryptogenic cerebral abscess caused by Raoultella ornithinolityca isolated from the brain, with more than 1-year follow-up.
Insights
This case report details a rare cryptogenic cerebral abscess caused by Raoultella ornithinolityca. The patient underwent successful neurosurgical treatment for the brain abscess.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Microbiology
Background:
- Cerebral abscesses are life-threatening neurosurgical conditions.
- Despite advances, treatment remains challenging.
Observation:
- A 64-year-old woman presented with a right frontobasal brain abscess and orbital mass.
- She also had inflammatory sinusopathy affecting multiple sinuses.
- Initial antimicrobial therapy and observation showed abscess growth on CT scan.
Findings:
- The patient underwent successful neurosurgical intervention for the brain abscess.
- This is the first reported case of a cryptogenic cerebral abscess caused by Raoultella ornithinolityca.
- The patient had a favorable outcome, with residual visual compromise in the right eye.
Implications:
- This case expands the spectrum of pathogens causing cerebral abscesses.
- Highlights the importance of considering rare bacteria in cryptogenic cases.
- Emphasizes the need for prompt diagnosis and multidisciplinary management of brain abscesses.
