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Pyogenic brain abscess caused by Streptococcus pneumoniae: case report and review

E Grigoriadis1, W L Gold

  • 1Division of General Internal Medicine, The Toronto Hospital, University of Toronto, Ontario, Canada.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|December 24, 1997
PubMed

Insights

Pneumococcal brain abscesses, though rare, can occur in adults, often linked to ear infections. Streptococcus pneumoniae can cause serious brain abscesses with significant mortality and long-term deficits.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Streptococcus pneumoniae is a leading cause of bacterial meningitis in adults.
  • Brain abscesses caused by S. pneumoniae are uncommon but serious infections.

Observation:

  • A case of otogenic brain abscess caused by S. pneumoniae is presented in a patient treated with ciprofloxacin for otitis media.
  • A review of 23 previously reported cases of pyogenic brain abscess caused by S. pneumoniae is included.

Findings:

  • Pneumococcal brain abscesses were associated with contiguous intracranial infection in 50% of cases.
  • Headache (81%) and focal neurological deficits (86%) were common presenting symptoms.
  • The classic triad of headache, fever, and focal neurological deficits was present in only 24% of patients.

Implications:

  • The mortality rate for pneumococcal brain abscess is high at 35%.
  • Forty percent of survivors experienced persistent neurological deficits.
  • Early recognition and treatment are crucial for improving outcomes in pneumococcal brain abscess.

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