Published online Jul 16, 2017. doi: 10.12998/wjcc.v5.i7.299
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
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.
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.