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Disseminated intra-cerebral microabscesses: a clinico-pathologic study
V V Radhakrishnan1, A Saraswathy, D Rout
1Department of Pathology, Sree Chitra Tirunal Institute for Medical Science and Technology, Trivandrum.
Abstract:
In this retrospective study, clinical and neuropathological features were analysed in eight patients with disseminated intracerebral microabscesses. All the patients presented with clinical features, suggestive of an encephalopathic process of an acute onset. Neuroradiological and laboratory investigations were not helpful in establishing the diagnosis in any patient during their hospital stay. All the eight patients died in the hospital and at autopsy disseminated intracerebral microabscesses were the most striking feature. In two patients hyphae of Candida albicans were demonstrated within the microabscesses. Gram negative bacilli in two patients and gram positive and gram positive cocci in one patient were demonstrated in the microabscesses. Disseminated intra-cerebral microabscesses are usually an unrecognised manifestation of central nervous system infections and should be considered in the differential diagnosis of patients with encephalopathy of unknown aetiology.
Insights
Disseminated intracerebral microabscesses, often undetected during life, are a significant finding in unexplained encephalopathy. Autopsies revealed these microabscesses as the primary cause of death in eight patients.
Area of Science:
- Neuropathology
- Infectious Diseases
- Neuroscience
Background:
- Disseminated intracerebral microabscesses are a rare but serious condition.
- Diagnosis is often challenging due to non-specific clinical presentations.
- Encephalopathy of unknown etiology requires thorough investigation.
Purpose of the Study:
- To analyze the clinical and neuropathological features of disseminated intracerebral microabscesses.
- To highlight the diagnostic challenges and autopsy findings in such cases.
- To emphasize the importance of considering microabscesses in the differential diagnosis of encephalopathy.
Main Methods:
- Retrospective analysis of clinical and neuropathological data.
- Review of eight patient cases with disseminated intracerebral microabscesses.
- Autopsy examination to identify causative agents.
Main Results:
- All eight patients presented with acute encephalopathy.
- Neuroradiological and laboratory tests were inconclusive for diagnosis.
- Autopsy revealed disseminated microabscesses as the main pathological finding.
- Microbial agents identified included Candida albicans, Gram-negative bacilli, and Gram-positive cocci.
Conclusions:
- Disseminated intracerebral microabscesses are frequently unrecognized during life.
- These microabscesses are a critical consideration in the differential diagnosis of acute encephalopathy.
- Prompt identification and treatment of CNS infections are crucial.