• Journal of Korean Neurosurgical Society
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• v.43 no.1
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• pp.37-40
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• 2008

Brucellosis, a zoonosis with worldwide distribution, is a systemic infection caused by facultative intracellular bacteria of the genus Brucella, which can involve multiple organs and tissues. We report an uncommon case of spondylodiscitis with epidural abscess due to Brucella in a male stockbreeder. Diagnosis was based on clinical history, and supported by Brucella serology and magnetic resonance imaging. Clinical and radiological improvement were observed with a combined antimicrobial therapy of doxycycline, rifampicin, and gentamycin.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1140-1143
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• 2001

The mortality of patients with brain abscess has decreased significaltly. This has been attributed to improved diagnostic imaging, the evolution of neurosurgical techniques and understanding of intracranial pressure pathophysiology, greater critical care understanding, and newer antibiotics. However, the mortality associated with intraventricular rupture of brain abscess remained consistently high at or above 80% once identified. A case of intraventicular rupture of thalamic abscess with good quality of survival is presented based on aggressive 4-component therapeutic plan used. The four components are 1) extraventricular drainage for 6 weeks, 2) lavage of the ventricular system using closed irrigation system, 3) intravenous antibiotics, 4) intraventricular gentamicin and vancomycin, twice and once daily, respectively.

• Investigative Magnetic Resonance Imaging
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• v.7 no.1
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• pp.31-38
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• 2003

Purpose : To analyze the serial changes of proton magnetic resonance (MR) spectra in the abscess and to determine the effect of the antibiotic treatment on the metabolite patterns. Materials and Methods : MR imaging and MR spectroscopy of an experimentally induced abscess were performed sequentially for four weeks at interval of one week in both the control group (n=5) and the antibiotic treatment group (n=5). On MR imaging, the shape and the size of the abscess were analyzed. On MR spectroscopy, the resonance peaks of metabolites were assigned on the basis of reported peaks in the literature. The metabolite ratios measured by using N-acetyl alanine as an external reference and by using lipid as an internal reference were compared in both the control and treatment g roups. Results : The abscesses were seen as cystic masses on MR imaging. On MR spectroscopy, the variable peaks of acetate, succinate and various amino acids, which are the metabolites of infection, were identified in the control and antibiotic treatment groups. The most frequent peak was that of acetate at 1.92ppm (70%). Both the peak ratios of acetate to lipid and acetate to external reference tended to decrease in the treatment group while the ratios did not change significantly in the control group. Conclusion : MR spectroscopy is useful not only for the diagnosis of abscess but also for monitoring the evolution of the abscess by using the acetate peak.

• Investigative Magnetic Resonance Imaging
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• v.17 no.1
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• pp.47-49
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• 2013

Endogenous endophthalmitis is rare and refers to an intraocular inflammatory process that may result from exogenous or endogenous causes. Magnetic resonance imaging (MRI) is useful for diagnosing endophthalmitis, and valuable to reach the diagnosis of brain abscess. We report here the MR findings of simultaneously developed endogenous endophthalmitis and brain abscesses.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.266-270
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• 2006

A case of an epidural abscess, a rare but possibly devastating complication of epidural instrumentation and catheterization, which occurred in a cancer pain patient with an epidural port connected to the epidural catheter, is described. Although cases of a catheter related epidural abscess have been intermittently reported, those following epidural port implantation are very rare, with no case having been reported in Korea. Herein, the case of a 31-year-old man, who developed an epidural abscess 54 days after subcutaneous implantation of an epidural port connected to an epidural catheter, is reported. Methicillin-sensitive staphylococcus aureus was detected in a culture of the purulent discharge. Magnetic resonance imaging was essential, not only for the diagnosis of the epidural abscess, but also for determining the extent of spread. The patient refused further evaluation and treatment, and expired 22 days later.

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.146-149
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• 2005

Most primary spinal abscesses, irrespective of pathogens and anatomical locations, have better prognosis than that of secondary abscesses with spondylitis. We report a 68-year-old man, previously undertaken pulmonary resection due to tuberculosis, presented with paraparesis. Imaging studies showed primary intraspinal abscesses at T-1 and T-3 vertebral levels, semi-invasive pulmonary Aspergillosis and inflammation of the posterior mediastinum. Operative procedure and histopathological examination revealed interdural Aspergillus abscess. Despite chemotherapy, he deteriorated progressively, and spondylitis developed at corresponding vertebrae. He eventually died 6 weeks postoperatively due to pulmonary complication. The authors intended to inform that such an extradural inflammatory lesion of Aspergillus abscess should be treated carefully.

• Journal of Korean Foot and Ankle Society
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• v.28 no.1
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• pp.36-39
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• 2024

Lupus panniculitis is a rare disease that may present with similar clinical manifestations to an infection, such as cellulitis or abscess. This paper reports a case of a 25-year-old woman with systemic lupus erythematosus who underwent surgical intervention initially with the suspicion of an abscess but who was eventually diagnosed with lupus panniculitis. Despite the low incidence of lower leg involvement of panniculitis, clinicians should be aware of the possibility of an etiology other than infection when encountering patients with inflammatory diseases. Moreover, a skin biopsy and magnetic resonance imaging with a diffusion-weight image may be helpful.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.275-279
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• 2018

A brain abscess is caused by an infection in the central nervous system and leads to significant neurological sequelae. Despite advances in neurocritical care, high morbidity and mortality rates are still associated with brain abscess, especially in certain high-risk patients. Thus, a brain abscess is a medical emergency requiring prompt diagnosis and treatment with antibacterial therapy. However, the recurrence of brain abscess is rare. A 59-year-old man presented at our neurology clinic with a headache and was found to have chronic otitis media. Serial brain magnetic resonance imaging (MRI) scans of the patient demonstrated a brain abscess in the right frontal lobe. Following stereotactic aspiration of the brain abscess and proper antimicrobial treatment, the patient recovered completely. Five months after discharge, the patient revisited our clinic with a headache and seizure symptoms, and recurrence of the brain abscess was confirmed by brain MRI. Recurrent brain abscess has been documented in patients with predisposing conditions such as retained foreign bodies, chronic sinusitis, arteriovenous fistula, and right-to-left shunt.

• Childhood Kidney Diseases
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• v.28 no.1
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• pp.44-50
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• 2024

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that affects multiple organs. More than half of the patients with SLE have kidney involvement, and up to 10% of patients with lupus nephritis develop end-stage renal disease (ESRD). Central nervous system (CNS) involvement in SLE occurs in 21% to 95% of patients. Severe neurological manifestations such as seizures, cerebrovascular disease, meningitis, and cerebrovascular accidents can develop in childhood-onset SLE, but cerebral infections, such as brain abscess and hemorrhage, are seldom reported in lupus nephritis, even in adults. Here, we report a rare case of childhood-onset SLE with ESRD, cerebral abscess, and hemorrhage. A 9-year-old girl diagnosed with lupus nephritis was administered high-dose steroids and immunosuppressant therapy to treat acute kidney injury (AKI) and massive proteinuria. The AKI deteriorated, and after 3 months, she developed ESRD. She received hemodialysis three times a week along with daily peritoneal dialysis to control edema. She developed seizures, and imaging showed a brain abscess. This was complicated by spontaneous cerebral hemorrhage, and she became unstable. She died shortly after the hemorrhage was discovered. In conclusion, CNS complications should always be considered in clinical practice because they increase mortality, especially in those with risk factors for infection.

• Journal of Korean Neurosurgical Society
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• v.51 no.5
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• pp.316-319
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• 2012

A 24-year-old man presented with mental change, fever, abdominal pain, tenderness and palpable mass on the lower abdomen. He was a non-Korean engineer and did not accompany a legal guardian, so medical history taking was difficult due to his mental status. Brain magnetic resonance imaging showed multiple rim-enhanced lesions of the brain, and abdominal computed tomography showed huge paraspinal abscess. Chest X-ray and computed tomography showed poorly defined nodular opacities. We initially thought that this patient was infected with toxoplasmosis with typical cerebral image finding and immunoglobulin laboratory finding of cerebrospinal fluid and serum study. The abdominal abscess was confirmed as tuberculosis through the pathologic finding of caseous necrosis. We used anti-tuberculosis medication and anti-toxoplasmosis medication for almost 4 months, and then his clinical state and radiological findings were considerably improved.