Idiopathic pontine Streptococcus salivarius abscess in an immunocompetent patient: Management lessons through case illustration and literature review

Aimee Luna Mandapat, Christopher S. Eddleman, Mei Lin Bissonnette, H. Hunt Batjer, Teresa R. Zembower

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)837-847
Number of pages11
JournalScandinavian Journal of Infectious Diseases
Volume43
Issue number11-12
DOIs
StatePublished - Dec 1 2011

Keywords

  • Abscess
  • Immunocompetent
  • Management
  • Pontine
  • Streptococcus

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

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