A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents
Authors: Alessandra Iacono, Agnese Maria Addeo, Cristina Ferre, Paola Gallo, Sara Bertelli, Monica Sprocati, Luca Borgatti, Giuseppe Maggiore
Background: A brain abscess is a rare but serious complication of sinusitis. It mostly involves adolescents and more specifically those of the male sex. A cerebral abscess is characterized by a heterogeneous clinical picture. The pathogenic organism mostly involved belongs to the Streptococcus milleri group. The diagnosis process is based on imaging. Treatment is based on an antibiotic therapy for 4-8 weeks which can be followed by surgery. Long-term sequelae occur in 40% of the cases, and mortality is about 10%. Case Presentation: This paper reports the clinical case of a 16-year-old boy affected by a sinusitis-induced brain abscess. The worsening of the clinical picture and of the neuroimaging, despite antibiotic therapy, made a surgical intervention necessary. An intravenous antibiotic therapy was administered for 2 weeks followed by oral antibiotics. Despite this, the condition of the patient was worsening, and he had to be treated again with intravenous antibiotic therapy for 4 weeks. This therapeutic choice had a positive outcome and the boy was declared healed. Conclusion: Sinusitis is an infection that can be complicated by brain abscess in 6%-8% of cases. Large-sized cerebral abscesses accompanied by neurological symptoms require prompt surgical treatment and a targeted antimicrobial therapy to reduce hospitalization and to speed up the healing process.
Keywords: Case report, brain abscess, sinusitis.
Authors
Correspondence to:
Alessandra Iacono, Department of Medical Sciences and Pediatrics, University of Ferrara, University Hospital Arcispedale Sant’ alessandraiacono@alice.it
Publication history:
Received 09 Nov 2019
Revised 27 Jul 2020
Accepted 09 Aug 2020
Published online 07 Oct 2020
Published in print 17 Oct 2020
Iacono A, Addeo AM, Ferre C, Gallo P, Bertelli S, Sprocati M, Borgatti L, Maggiore G. A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents. EJMCR. 2020; 4(9): 288-291. doi:
10.24911/ejmcr/173-1573302070
Iacono A, Addeo AM, Ferre C, Gallo P, Bertelli S, Sprocati M, Borgatti L, Maggiore G. A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents. https://www.ejmcr.com/?mno=73017 [Access: March 29, 2024]. doi:
10.24911/ejmcr/173-1573302070
Iacono A, Addeo AM, Ferre C, Gallo P, Bertelli S, Sprocati M, Borgatti L, Maggiore G. A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents. EJMCR. 2020; 4(9): 288-291. doi:
10.24911/ejmcr/173-1573302070
Iacono A, Addeo AM, Ferre C, Gallo P, Bertelli S, Sprocati M, Borgatti L, Maggiore G. A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents. EJMCR. (2020), [cited March 29, 2024]; 4(9): 288-291. doi:
10.24911/ejmcr/173-1573302070
Iacono, A., Addeo, . A. M., Ferre, . C., Gallo, . P., Bertelli, . S., Sprocati, . M., Borgatti, . L. & Maggiore, . G. (2020) A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents. EJMCR, 4 (9), 288-291. doi:
10.24911/ejmcr/173-1573302070
Iacono, Alessandra, Agnese Maria Addeo, Cristina Ferre, Paola Gallo, Sara Bertelli, Monica Sprocati, Luca Borgatti, and Giuseppe Maggiore. 2020. A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents. European Journal of Medical Case Reports, 4 (9), 288-291. doi:
10.24911/ejmcr/173-1573302070
Iacono, Alessandra, Agnese Maria Addeo, Cristina Ferre, Paola Gallo, Sara Bertelli, Monica Sprocati, Luca Borgatti, and Giuseppe Maggiore. "A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents." European Journal of Medical Case Reports 4 (2020), 288-291. doi:
10.24911/ejmcr/173-1573302070
Iacono, Alessandra, Agnese Maria Addeo, Cristina Ferre, Paola Gallo, Sara Bertelli, Monica Sprocati, Luca Borgatti, and Giuseppe Maggiore. "A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents." European Journal of Medical Case Reports 4.9 (2020), 288-291. Print. doi:
10.24911/ejmcr/173-1573302070
Iacono, A., Addeo, . A. M., Ferre, . C., Gallo, . P., Bertelli, . S., Sprocati, . M., Borgatti, . L. & Maggiore, . G. (2020) A case report of brain abscess caused by Streptococcus intermedius secondary to sinusitis in 16-year-old adolescents. European Journal of Medical Case Reports, 4 (9), 288-291. doi:
10.24911/ejmcr/173-1573302070