Drastic Therapy for Listerial Brain Abscess Involving Combined Hyperbaric Oxygen Therapy and Antimicrobial Agents

Journal of Clinical Neurology 2014³â 10±Ç 4È£ p.358 ~ p.362

(Nakahara Keiichi) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Yamashita Satoshi) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Ideo Katsumasa) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Shindo Seigo) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Suga Tomohiro) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Ueda Akihiko) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Honda Shoji) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Hirahara Tomoo) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Watanabe Masaki) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Yamashita Taro) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Maeda Yasushi) - Kumamoto University Graduate School of Medical Sciences Department of Neurology
(Yonemochi Yasuhiro) - Kumamoto Medical Center National Hospital Organization Department of Neurology
(Takita Tomohiro) - Kumamoto Medical Center National Hospital Organization Department of Neurology
(Ando Yukio) - Kumamoto University Graduate School of Medical Sciences Department of Neurology

Abstract

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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brain abscess, Listeria monocytogenes, subtentorial lesions, surgical drainage, hyperbaric oxygen therapy, antimicrobial agents
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