Multiple Brain Abscesses: An Unusual Case

Abstract

Brain abscess is a collection of pus with a vascular capsule beginning as a cerebritis at its early stage. The incidence rate of brain abscess is approximately 0.13-0.9 per 100,000 person-year. In 33% of cases, brain abscess is spread hematogenously, mostly with endocarditis (13%), pulmonary infection (8%), or dental infection (5%). Other cases are attributed to recent neurosurgeries (9%) or cranial traumas (14%). Streptococcus and Staphylococcus species are the most common microorganisms causing brain abscesses. The symptoms presented include headache, fever, nausea, vomiting, focal neurologic symptoms, lethargy, and seizure. In this study, a 44-year-old coal worker methadone-abuser man who was admitted with the presentation of altered mental status, headache, imbalance, and vertigo with widespread ring-enhancing lesions in his brain caused by multiple brain abscesses due to solitary lung abscess without pulmonary disease symptoms is reported. Altered consciousness and dysphagia were considered as a cause for his aspiration.

Keywords

• multiple brain abscesses
• hematogenous spread
• confusional state
• ring enhancing lesion