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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Antimicrobial management of unresectable embolisation agent infection: A case report
Timothy D Shaw1, Suhani Bansal2, Jun Lau3
1Department of Infectious Diseases, Belfast Health and Social Care Trust, UK; School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, UK.
Abstract:
Liquid embolisation agents represent an uncommon but serious site of intracranial infection. Surgical excision of the infected material is typically required to eradicate infection and outcomes are poor in inoperable cases due to recurrent, treatment-refractory ventriculitis. We present our case in whom retained E. coli-infected embolisation glue was managed with antimicrobial therapy only. Following multiple failed courses of antibiotics, we found an aggressive induction phase (12 weeks intravenous therapy) followed by lifelong suppressive oral therapy resulted in sustained clinical recovery at one year's follow-up.
Insights
Intracranial infection from liquid embolisation agents is rare but serious. This case shows successful management of retained, infected embolisation glue using intensive intravenous antibiotics followed by lifelong oral therapy, achieving sustained recovery.
Area of Science:
- Neuroscience
- Infectious Diseases
- Medical Device Complications
Background:
- Liquid embolisation agents can cause uncommon intracranial infections.
- Surgical removal is standard but often not feasible, leading to poor outcomes.
- Recurrent, treatment-refractory ventriculitis is a significant challenge in these cases.
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