A 26-year-old woman with brainstem abscess at third trimester of pregnancy: Case report

Abstract

We describe an unusual case with a modified treatment approach in an interdisciplinary setting, of a pregnant woman with a pyogenic pontine abscess. After acute cesarean section, contrast-enhanced MRI confirmed the finding of severe pontine abscess. The patient was treated with antibiotics, glucocorticosteroids, and acute stereotactic evacuation. She improved during eight weeks of treatment with antibiotics and steroids, and the post-operative MRI showed reduction in abscess size and brainstem edema. The patient recovered to a near-normal state of CNS function, with only slight sensory deficits remaining at the nine-month follow-up. The suggested main cause of successful outcome in this rare case was acute stereotactic evacuation of the pontine abscess in combination with postoperative cavity injection of antibiotic solution (Vancomycin 5 mg) and modified broad-spectrum antibiotics due to the polymicrobial etiology. The main bullet point and the aim of this article is to emphasize the importance of modified antibiotic treatment in combination with an interdisciplinary approach for related cases.

Keywords

• Stereotactic evacuation
• Pontine abscess
• Polymicrobial
• Pregnancy
• Vancomycin