[A case of amebic brain abscess]. 2007

Akitsugu Morishita, and Hirotaka Yamamoto, and Hideo Aihara
Department of Neurosurgery, Toyooka Hospital, 1094 Tobera, Toyooka-shi, Hyogo 668-8501, Japan.

Amebic brain abscess is a rare and usually fatal complication of Entamoeba histolytica infections. We successfully treated a patient with this infection accompanied by brain, liver and pulmonary abscesses. Treatment consisted of administration of metronidazole through a nasogastric tube, and drainage of the brain abscess. A 51-year-old male patient presented with a two-week history of fever, severe back pain, and chest pain. Liver and pulmonary abscesses were drained upon admission. Biopsy of the colon showed infection by Entamoeba histolytica. After oral administration of metronicazole, the patient became somnolent, and neurological examination showed left side weakness. CT scan and MRI of the brain disclosed an abnormal lesion in the right basal ganglia. He was then transferred to our department, where stereotactic aspiration with drainage of the brain abscess was performed. The abscess was filled with reddish purulent material. Treatment with metronidazole (1,200 mg daily) for 18 days resulted in almost complete resolution of the intracerebral lesion and survival of the patient without any neurological deficits. His general condition improved dramatically, and he was discharged from our hospital 2 months later. Only 14 cases with amebic brain abscess associated with Entamoeba histolytica infection who recovered after treatment have been reported. We suggest amebic brain abscess should be taken into consideration for patients with brain abscess with a history of dysenteric illness especially since early diagnosis and aggressive management is likely to result in a cure.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008795 Metronidazole A nitroimidazole used to treat AMEBIASIS; VAGINITIS; TRICHOMONAS INFECTIONS; GIARDIASIS; ANAEROBIC BACTERIA; and TREPONEMAL INFECTIONS. 2-Methyl-5-nitroimidazole-1-ethanol,Bayer 5360,Clont,Danizol,Flagyl,Gineflavir,Metric,MetroGel,Metrodzhil,Metrogyl,Metronidazole Hydrochloride,Metronidazole Monohydrochloride,Metronidazole Phosphate,Metronidazole Phosphoester,Satric,Trichazol,Trichopol,Trivazol,Vagilen,2 Methyl 5 nitroimidazole 1 ethanol
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001922 Brain Abscess A circumscribed collection of purulent exudate in the brain, due to bacterial and other infections. The majority are caused by spread of infected material from a focus of suppuration elsewhere in the body, notably the PARANASAL SINUSES, middle ear (see EAR, MIDDLE); HEART (see also ENDOCARDITIS, BACTERIAL), and LUNG. Penetrating CRANIOCEREBRAL TRAUMA and NEUROSURGICAL PROCEDURES may also be associated with this condition. Clinical manifestations include HEADACHE; SEIZURES; focal neurologic deficits; and alterations of consciousness. (Adams et al., Principles of Neurology, 6th ed, pp712-6) Brain Abscess, Child,Brain Abscess, Multiple,Brain Abscess, Pyogenic,Brain Abscess, Sterile,Cerebral Abscess,Abscess, Brain,Abscess, Cerebral,Abscess, Child Brain,Abscess, Multiple Brain,Abscess, Pyogenic Brain,Abscesses, Cerebral,Abscesses, Multiple Brain,Brain Abscesses,Brain Abscesses, Multiple,Brain Abscesses, Pyogenic,Brain Abscesses, Sterile,Cerebral Abscesses,Child Brain Abscess,Multiple Brain Abscess,Multiple Brain Abscesses,Pyogenic Brain Abscess,Pyogenic Brain Abscesses,Sterile Brain Abscess,Sterile Brain Abscesses
D004322 Drainage The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
D004748 Entamoeba histolytica A species of parasitic protozoa causing ENTAMOEBIASIS and amebic dysentery (DYSENTERY, AMEBIC). Characteristics include a single nucleus containing a small central karyosome and peripheral chromatin that is finely and regularly beaded. Endamoeba histolytica,histolytica, Endamoeba
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000562 Amebiasis Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. Abscess, Amebic,Acanthamebiasis,Ameboma,Amoebiasis,Iodamoebiasis,Acanthamoeba Infection,Balamuthia Infection,Abscesses, Amebic,Acanthamebiases,Acanthamoeba Infections,Amebiases,Amebic Abscess,Amebic Abscesses,Amoebiases,Balamuthia Infections,Infection, Acanthamoeba,Infection, Balamuthia,Iodamoebiases
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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