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KMID : 1130620140100040358
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Journal of Clinical Neurology
2014 Volume.10 No. 4 p.358 ~ p.362
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Drastic Therapy for Listerial Brain Abscess Involving Combined Hyperbaric Oxygen Therapy and Antimicrobial Agents
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Nakahara Keiichi
Yamashita Satoshi
Ideo Katsumasa
Shindo Seigo
Suga Tomohiro
Ueda Akihiko
Honda Shoji
Hirahara Tomoo
Watanabe Masaki
Yamashita Taro
Maeda Yasushi
Yonemochi Yasuhiro
Takita Tomohiro
Ando Yukio
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Abstract
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Background: Listeria monocytogenes (L. monocytogenes) is a rare causative pathogen of brain abscess that is often found in immunocompromised patients. Although patients with supratentorial listerial abscesses showed a longer survival with surgical drainage, the standard therapy for patients with subtentorial lesions has not been established.
Case Report: We report herein a patient with supra- and subtentorial brain abscesses caused by L. monocytogenes infection. These abscesses did not respond to antibiotics, and his symptoms gradually worsened. Drainage was not indicated for subtentorial lesions, and the patient was additionally treated with hyperbaric oxygen therapy, which dramatically reduced the volume of abscesses and improved the symptoms.
Conclusions: This is the first report of drastic therapy for a patient with listerial brain abscesses involving combined antibiotics and hyperbaric oxygen therapy. The findings suggest that hyperbaric oxygen therapy is a good option for treating patients with deep-seated listerial abscesses and for who surgical drainage is not indicated.
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KEYWORD
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brain abscess, Listeria monocytogenes, subtentorial lesions, surgical drainage, hyperbaric oxygen therapy, antimicrobial agents
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