Iatrogenic cerebral abscess leading to resolution of severe delusional disorder

Area of Science:

• Neurology
• Psychiatry
• Infectious Diseases

Background:

• Cerebral abscesses (focal brain infections) typically have high mortality and morbidity.
• Iatrogenic cerebral abscesses, often resulting from medical procedures, are less common but significant.
• This case involves a patient with a history of congenital hydrocephalus, cerebral palsy, and organic delusional disorder.

Observation:

• A 32-year-old female developed an iatrogenic cerebral abscess following the insertion of an intracranial pressure monitoring device.
• The patient had a complex medical history including congenital hydrocephalus and cerebral palsy.
• She presented with a severe psychotic disorder.

Findings:

• Treatment with 6 weeks of intravenous meropenem led to the resolution of the cerebral abscess.
• The patient's severe psychotic disorder rapidly improved, with stabilization and euthymia.
• Post-treatment, the patient experienced no further delusions or hallucinations.

Implications:

• This case suggests a potential, albeit rare, therapeutic benefit of cerebral abscesses in specific psychiatric contexts.
• It underscores the importance of considering neurological complications in patients with psychiatric disorders and invasive devices.
• Successful antibiotic treatment of an iatrogenic cerebral abscess can lead to significant psychiatric recovery and improved quality of life.