Brain Surgiceloma and Concomitant Brain Abscess by Cutibacterium acnes: A Case Report

Abstract

Introduction: Oxidized cellulose is a widely used hemostatic material during neurosurgery procedures due to its sterile and bioabsorbable properties. Nevertheless, it can be involved in granulomatous reactions leading to edema, cell migration, and compression of adjacent tissues. Case description: Herein, we report the case of a patient with impaired neurological status 13 days after a frontal lobe cavernoma resection. Initially, a brain abscess was considered based on the Computed Tomography Scan (CT) pattern. Empirical antibiotic therapy was initiated. He was taken to emergency drainage of a brain abscess based on images, with pathology and surgical findings compatible with a granulomatous reaction associated with hemostatic agents and isolation of cutibacterium acnes in postoperative cultures. Adjustments in the antibiotic therapy were made according to the culture results. Discussion: Despite its rarity, foreign body granulomas due to hemostatic agents should be considered as a differential diagnosis to neurological impairment in the postoperative period, bearing in mind its routinary use. To our knowledge, there are no reports of brain surgicelomas and concomitant brain abscess caused by cutibacterium acnes.

Keywords

• Surgiceloma
• Brain abscess
• Cutibacterium acnes
• Granulomatous reaction