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Successful treatment of recurrent cerebral empyema and brain abscesses with imipenem
J A Carton1, F Perez, J A Maradona
1Infectious Disease Unit, Hospital Nuestra Señora de Covadonga, Universidad de Oviedo, Spain.
Abstract:
Imipenem was successfully used to treat a case of subdural empyema complicated by multiple cerebral abscesses, in which surgery and therapy with other antibiotics had previously failed. Imipenem concentrations in serum, cerebrospinal fluid and the cerebral abscess were much higher than the MICs for the infecting organisms, qualifying this antibiotic as an effective option in therapy of suppurative intracranial infections.
Insights
Imipenem effectively treated a complex brain infection when other treatments failed. High drug levels in the brain and cerebrospinal fluid confirmed its efficacy for suppurative intracranial infections.
Area of Science:
- Infectious Diseases
- Neuroscience
- Pharmacology
Background:
- Subdural empyema and cerebral abscesses are severe intracranial infections.
- Treatment failure with conventional antibiotics necessitates alternative therapeutic strategies.
Observation:
- A patient with subdural empyema and multiple cerebral abscesses did not respond to prior surgical and antibiotic interventions.
- Imipenem therapy was initiated for this refractory case.
Findings:
- Imipenem treatment led to successful resolution of the subdural empyema and cerebral abscesses.
- Therapeutic concentrations of imipenem were achieved in serum, cerebrospinal fluid, and the cerebral abscess site.
- Achieved imipenem levels significantly exceeded the minimum inhibitory concentrations (MICs) of the causative microorganisms.
Implications:
- Imipenem represents a viable therapeutic option for complicated suppurative intracranial infections.
- This case highlights the potential of imipenem in treating infections resistant to standard therapies.
- Further investigation into imipenem's role in neurosurgical infections is warranted.