TY - JOUR
T1 - Idiopathic pontine Streptococcus salivarius abscess in an immunocompetent patient
T2 - Management lessons through case illustration and literature review
AU - Mandapat, Aimee Luna
AU - Eddleman, Christopher S.
AU - Bissonnette, Mei Lin
AU - Batjer, H. Hunt
AU - Zembower, Teresa R.
PY - 2011/12
Y1 - 2011/12
N2 - A 55-y-old woman with no previous medical history presented with a 3-day history of progressive headache, nausea, emesis, right-sided facial numbness, and right-sided extremity weakness. Serial magnetic resonance imaging demonstrated rapid enlargement of a left-sided ring-enhancing dorsal pontine lesion with an exophytic portion, raising concern for an abscess. A stereotactically guided left-sided retrosigmoid craniotomy for abscess incision and decompression was performed given the rapid progression of her neurological deficits. Streptococcus salivarius was isolated from the intra-operative samples. After an extensive evaluation, no source for the S. salivarius was identified. Solitary brainstem abscesses are uncommon intracranial infections with high morbidity and mortality. Patients can present with non-specific symptoms and often have no previous medical history. Since 1974, 40 patients with solitary brainstem abscess have survived to hospital discharge. We outline management strategies for solitary brainstem abscess based on a literature review of survivors.
AB - A 55-y-old woman with no previous medical history presented with a 3-day history of progressive headache, nausea, emesis, right-sided facial numbness, and right-sided extremity weakness. Serial magnetic resonance imaging demonstrated rapid enlargement of a left-sided ring-enhancing dorsal pontine lesion with an exophytic portion, raising concern for an abscess. A stereotactically guided left-sided retrosigmoid craniotomy for abscess incision and decompression was performed given the rapid progression of her neurological deficits. Streptococcus salivarius was isolated from the intra-operative samples. After an extensive evaluation, no source for the S. salivarius was identified. Solitary brainstem abscesses are uncommon intracranial infections with high morbidity and mortality. Patients can present with non-specific symptoms and often have no previous medical history. Since 1974, 40 patients with solitary brainstem abscess have survived to hospital discharge. We outline management strategies for solitary brainstem abscess based on a literature review of survivors.
KW - Abscess
KW - Immunocompetent
KW - Management
KW - Pontine
KW - Streptococcus
UR - http://www.scopus.com/inward/record.url?scp=80755171288&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80755171288&partnerID=8YFLogxK
U2 - 10.3109/00365548.2011.593544
DO - 10.3109/00365548.2011.593544
M3 - Review article
C2 - 21756019
AN - SCOPUS:80755171288
SN - 0036-5548
VL - 43
SP - 837
EP - 847
JO - Scandinavian Journal of Infectious Diseases
JF - Scandinavian Journal of Infectious Diseases
IS - 11-12
ER -