A case of brain abscess successfully treated with continuous irrigation therapy

Some reports are suggesting the efficacy of continuous irrigation therapy for brain abscesses, but the way how to irrigate and perfusion abscesses and cerebral spinal fluid has not yet been established. Here, we present the case of successfully treated by continuous irrigation therapy for the severe bacterial brain abscess, meningitis, and encephalitis.

A 62-year-old man presented to our hospital with a chief complaint of headache and vomiting. Magnetic resonance imaging revealed an encapsulated lesion with peripheral contrast in the left cerebellar hemisphere, and the lesion showed high signal intensity on diffusion-weighted imaging. We diagnosed him with a brain abscess. In addition to drainage of the cerebellar lesion by small craniotomy and systemic administration of antibiotics, continuous irrigation therapy was performed for 7 days until the cell count of the cerebrospinal fluid became negative. Saline with antibiotics was infused through from ventricular drain, which was inserted through the anterior horn of the lateral ventricle to spiral drainage. His state of consciousness improved, and he was able to live at home.

Our proposed novel continuous irrigation therapy may lead to a positive outcome in brain abscesses.