Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2017; 5(7): 299-302
Published online Jul 16, 2017. doi: 10.12998/wjcc.v5.i7.299
Rare case of cryptogenic brain abscess caused by Raoultella ornithinolityca
Marianna Luongo
Marianna Luongo, Department of Neurosurgery, San Carlo Hospital, 85100 Potenza, Italy
Author contributions: Luongo M finished this manuscript solely.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at San Carlo Hospital, Potenza.
Informed consent statement: The patient involved gave her verbal informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: The author has no conflict of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Marianna Luongo, MD, Department of Neurosurgery, San Carlo Hospital, via Potito Petrone, 85100 Potenza, Italy. marianna.luongo@gmail.com
Telephone: +39-338-9754505 Fax: +39-971-612535
Received: November 12, 2016
Peer-review started: November 13, 2016
First decision: February 17, 2017
Revised: March 2, 2017
Accepted: March 21, 2017
Article in press: March 22, 2017
Published online: July 16, 2017
Processing time: 243 Days and 5.9 Hours
Abstract

Cerebral abscess is a potentially fatal neurosurgical condition, despite improvements in technology, new antimicrobial agents and modern neurosurgical instruments and techniques. I report the case of a 64-year-old woman, affected by a right frontobasal brain abscess, compressing the homolateral frontal horn of lateral ventricle, with a second mass partially occupying the right orbital cavity. She presented also with inflammatory sinusopathy involving the right maxillary, ethmoid and frontal sinuses. After 14 d of clinical observation and antimicrobial therapy, the patient received a computed tomography scan, which showed growth of the cerebral mass, with a ring of peripheral contrast enhancement and surrounding edema. She promptly underwent neurosurgical treatment and recovered well, except for the sight in her right eye, which remained compromised, as before the operation. This is believed to be the first case of cryptogenic cerebral abscess caused by Raoultella ornithinolityca isolated from the brain, with more than 1-year follow-up.

Keywords: Brain abscess; Headache; Raoultella ornithinolityca; Visual loss

Core tip: Brain abscess is a focal intracranial infection that evolves in a collection of pus. It could have cryptogenic origin in 10%-35% of cases. I present a 64-year-old woman affected by a frontal brain abscess that was surgically treated, from which Raoultella ornithinolytica (R. ornithinolytica) was isolated. The patient, after > 1 year, is doing well, except for her right eye that had already lost its visual power before surgery. This is believed to be the first case of cryptogenic cerebral abscess caused by R. ornithinolytica.