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Drastic Therapy for Listerial Brain Abscess Involving Combined Hyperbaric Oxygen Therapy and Antimicrobial Agents
Authors:Keiichi Nakahara  Satoshi Yamashita  Katsumasa Ideo  Seigo Shindo  Tomohiro Suga  Akihiko Ueda  Shoji Honda  Tomoo Hirahara  Masaki Watanabe  Taro Yamashita  Yasushi Maeda  Yasuhiro Yonemochi  Tomohiro Takita  Yukio Ando
Affiliation:aDepartment of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.;bDepartment of Neurology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan.
Abstract:

Background

Listeria monocytogenes (L. monocytogenes) is a rare causative pathogen of brain abscess that is often found in immunocompromised patients. Although patients with supratentorial listerial abscesses showed a longer survival with surgical drainage, the standard therapy for patients with subtentorial lesions has not been established.

Case Report

We report herein a patient with supra- and subtentorial brain abscesses caused by L. monocytogenes infection. These abscesses did not respond to antibiotics, and his symptoms gradually worsened. Drainage was not indicated for subtentorial lesions, and the patient was additionally treated with hyperbaric oxygen therapy, which dramatically reduced the volume of abscesses and improved the symptoms.

Conclusions

This is the first report of drastic therapy for a patient with listerial brain abscesses involving combined antibiotics and hyperbaric oxygen therapy. The findings suggest that hyperbaric oxygen therapy is a good option for treating patients with deep-seated listerial abscesses and for who surgical drainage is not indicated.
Keywords:brain abscess   Listeria monocytogenes   subtentorial lesions   surgical drainage   hyperbaric oxygen therapy   antimicrobial agents
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