• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.148-150
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• 2013

Intracranial calcifications are relatively common computed tomographic findings in the field of neurosurgery, and cysticercosis, tuberculosis, HIV, and cryptococcus are acquired intracranial infections typically associated with calcifications. However, intracranial calcification caused by a bacterial brain abscess is rare. Here, we present a rare case of intracranial calcification caused by a bacterial brain abscess, from which staphylococcus hominis was isolated. To the best of our knowledge, no previous report has been published on intracranial calcification caused by bacterial brain abscess after decompressive craniectomy for traumatic brain injury. In this article, the pathophysiological mechanism of this uncommon entity is discussed and relevant literature reviewed.

• Journal of Korean Neurosurgical Society
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• 제41권6호
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• pp.391-396
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• 2007

Objective : This study was performed to review the clinical characteristics and operative results of brain abscess in order to define the therapeutic strategy for this disease. Methods : We reviewed the medical records and radiology images of brain abscess patients treated in our hospital during the last 16 years. A total of 35 cases included 23 males and 12 females, with the mean age of 48 years old. We excluded cases of postoperative, post traumatic, and fungal abscess. All patient underwent at least one surgical treatment such as stereotactic aspiration or craniotomy with excision. Results : Twenty seven [77.1%] patients presented with symptoms of increased intracranial pressure. The frontal lobe was the most common anatomical place, and streptococcal species were the most frequently encountered pathogens. The chronic pulmonary diseases and chronic otitis media are common underlying condition. Eighteen patients underwent stereotactic aspiration and 17 patients had excision of their abscess as an initial treatment. Seven patients had a repeated surgery, 6 of them had been treated with aspiration initially. At discharge, 60.0% patients showed a favorable outcome. Conclusion : The stereotactic drainage would be more suitable for the brain abscess located in deep and eloquent area. A large, solitary, and well-encapsulated lesion of superficial location could be best treated with complete excision, and this procedure was more definite because it is associated with less repeated surgery and showed more favorable outcome compared to aspiration surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.25.1-25.5
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• 2019

Background: Brain abscess is a life-threatening condition that occurs due to complications during a neurosurgical procedure, direct cranial trauma, or the presence of local or distal infection. Infection in the oral cavity can also be considered a source of brain abscess. Case presentation: A 45-year-old male patient was transported with brain abscess in the subcortical white matter. Navigation-guided abscess aspiration and drainage was performed in the right mid-frontal lobe, but the symptoms continued to worsen after the procedure. A panoramic radiograph showed alveolar bone resorption around the maxillary molars. The compromised maxillary molars were extracted under local anesthesia, and antibiotics were applied based on findings from bacterial culture. A brain MRI confirmed that the three brain abscesses in the frontal lobe were reduced in size, and the patient's symptoms began to improve after the extractions. Conclusion: This is a rare case report about multiple uncontrolled brain abscesses treated by removal of infection through the extraction of maxillary molars with odontogenic infection. Untreated odontogenic infection can also be considered a cause of brain abscess. Therefore, it is necessary to recognize the possibility that untreated odontogenic infection can lead to serious systemic inflammatory diseases such as brain abscess. Through a multidisciplinary approach to diagnosis and treatment, physicians should be encouraged to consider odontogenic infections as a potential cause of brain abscesses.

• Brain Tumor Research and Treatment
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• 제6권2호
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• pp.92-96
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• 2018

A 59-year-old patient with a history of hepatocellular carcinoma presented with decreased consciousness and left hemiparesis. A rim-enhanced mass lesion without diffusion restriction was observed in contrast-enhanced MRI including diffusion-weighted imaging. Based on these findings, metastatic brain tumor was suspected. However, brain abscess (BA) was diagnosed after multiple bacterial colonies were observed in aspiration biopsy. Initial conventional antibiotic treatment including vancomycin had failed, so linezolid was used as second-line therapy. As a result, infection signs and clinical symptoms were resolved. We report a case with atypical imaging features and antibiotic susceptibility of a BA in an immunocompromised patient undergoing chemotherapy.

• Journal of Korean Neurosurgical Society
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• 제44권6호
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• pp.382-384
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• 2008

Gas forming brain abscess is a rare disease caused by Klebsiella pneumoniae occurring in patients with impaired host defense mechanism such as diabetes mellitus or liver cirrhosis. A 59-year-old man with 2-year history of diabetes mellitus and 20-year history of liver cirrhosis presented to the hospital with headache. On the day after admission, severe headache was developed and he deteriorated rapidly. Brain CT showed a non-enhanced mass including multiple air density as well as surrounding edema seen in the right occipital lobe, and isodensity air-fluid level seen in the right lateral ventricle. Despite emergent ventricular drainage and intraventricular and intravenous administration of antibiotics, his condition progressively worsened to sepsis and to death after 5 days. Bacterial culture of blood and ventricular fluids disclosed a Gram (-) rod, Klebsiella pneumoniae. In this report we review the pathogenic mechanism and its management.

• Investigative Magnetic Resonance Imaging
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• 제17권1호
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• pp.50-54
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• 2013

노카디아병 (nocardiosis)은 actinomycetales 목, nocardia 과에 속하는 호기성 양성 간균에 의한 감염으로 노카디아종은 사람과 동물에서 국소적, 전신적인 화농성 질환을 일으킬 수 있다. 노카디아병은 일반적으로 기회감염으로 생기지만 감염자의 1/3은 면역기능이 정상이다. 저자들은 고령의 크론병 (Crohn's disease) 여자 환자에서 노카디아종에 의해 발생한 폐 노카디아병과 뇌농양의 증례를 보고하고자 한다. 이 병변은 영상 검사상 주위 부종을 동반하며 조영 증강을 보여 수술 전에는 종양으로 생각되었고, 전이성 뇌암처럼 공격적인 병의 진행을 보였다. 노카디아병의 조기 진단, 기저 질환이 없는 경우, 적절한 항생제 치료가 이루어 졌을 때 예후가 좋다. 저자들은 뇌에 생긴 노카디아병을 보고하여 자기공명영상과 컴퓨터 단층촬영 소견을 알리고 악성 병변과의 감별에 도움이 되고자 한다.

• Neonatal Medicine
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• 제18권2호
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• pp.399-403
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• 2011

신생아의 뇌 농양은 극히 드문 경우로 특정 선행 요인을 가지고 있는 경우가 많다. 가장 흔한 원인 균주는 그람 음성 균주이며 치료법의 발달로 사망률은 감소하였지만 반신 마비, 경련, 발달 장애 등의 후유증이 남을 수 있다. 39일 된 남아가 하루 전부터 시작된 발열을 주소를 내원하였다. 환아는 조산, 저 체중 출산아로 신생아 중환자실에 입원했던 경력이 있었다. 신체 검진상 대천문이 팽창된 것 외에 다른 신경학적 증후는 보이지 않았다. 신경 촬영 검사상 양측 전두엽에 정중선이 오른쪽으로 치우쳐 있는 뇌 농양으로 의심되는 거대한 병변이 있었다. 뇌 농양이 매우 컸음에도 불구하고 수술장으로 이동하지 않고 환자의 침상에서 직접 단순 흡입 치료를 시행하였고 항생제 치료를 병행하였다. 원인균은 Enterobacter cloacae로 판명되었고 meropenem을 8주간 투여 하였다. 환아는 빠른 회복을 보이며 이후 어떤 신경학적 휴유증도 보이지 않았다. 저자들은 Enterobacter cloacae 감염에 의한 거대한 뇌 농양이 발견된 신생아를 단순 흡입과 항생제 만으로 치료 하였고 이후 좋은 경과를 보인 1례를 경험하였기에 보고하는 바이다.

• 한국동물위생학회지
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• 제37권1호
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• pp.73-78
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• 2014

In February 2013, two Korean native goats with circling, dysphagia, sialorrhea, and death were submitted for necropsy to the Jeju Self-Governing Provincial Veterinary Research Institute. Histopathologically, multifocal to confluent micro-abscess composed of neutrophils and macrophages and severe multifocal perivascular cuffing were observed in pons, medulla oblongata, and cerebellum. Isolated bacteria from the brain sample were Gram-positive coccobacilli and were confirmed as Listeria (L.) monocytogenes by VITEK and PCR analysis. Based on clinical sign, histopathology and bacterial isolation, this case was diagnosed as encephalitic listeriosis. In our best knowledge, this is the first report of encephalitic listeriosis caused by L. monocytogenes in Korean native goats in Jeju.

• Pediatric Infection and Vaccine
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• 제27권1호
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• pp.62-68
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• 2020

급성 세균성 부비동염은 소아에서 흔하게 발생하는 질환 중 하나로, 바이러스성 상기도 감염 후 5-13%에서 동반하는 것으로 알려져 있다. 접형동에 국한된 부비동염이 발생할 확률은 모든 부비동염의 3% 미만이나 접형동의 구조적 특성상 주위 조직으로 감염이 전파되면 치명적일 수 있다. 비피막형 인플루엔자균(non-typeable Haemophilus influenzae[NTHi])은 급성 세균성 부비동염의 흔한 원인균이나 정상면역인 환아에서 균혈증으로 파급되는 경우는 매우 드물다. 저자들은 특별한 기저질환이 없는 소아가 발열과 두통으로 내원하여 균혈증을 동반한 NTHi에 의한 편측 접형동에 국한된 부비동염이 확인되어 항생제 및 수술적 치료로 호전된 예를 경험하여 보고하는 바이다.

• The Korean Journal of Pain
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• 제7권1호
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• pp.113-115
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• 1994

통증치료를 목적으로 통증치료실에서 경막외 카테타 거치술의 빈도가 증가하고 있으며 현재 지속적 경막외 차단은 통증치료실에서 가장 필수적인 치료수단으로 알려져 있다. 암성통증, 대상포진, 혈관폐쇄성질환, 요하지통 등 여러가지 질환에 따라 수일에서 수개월간 경막외 카테터를 거치하여 치료하고 있다. 합병증으로 장기간의 경막외 카테터 유치로 인한 경막외 감염의 가능성이 항상 존재하고 있고 경막외 농양 동의 경막외 감염중이 드물게 발생하며 세균성 뇌막염의 발생은 매우 희귀하다고 한다. 본원에서는 당뇨병환자로서 우하지의 당뇨병성 말초 신경염으로 인한 통증의 치료를 위해 시술한 지속적 경막외 차단 도중 발생한 세균성 뇌막염을 1예 경험하였으며 이와 같은 합병증을 예방하기 위하여 경막외 천자시, 경막외 카테터 거치후에 지속적인 카테터 관리와 약물주입시 무균조작의 중요성을 절감하여 문헌적 고찰과 함께 보고하는 바이다.