Drastic Therapy for Listerial Brain Abscess Involving Combined Hyperbaric Oxygen Therapy and Antimicrobial Agents
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Background Listeria monocytogenes (L. monocytogenes) is a rare causative pathogen ofbrain abscess that is often found in immunocompromised patients. Although patients with supratentorial listerial abscesses showed a longer survival with surgical drainage, the standardtherapy for patients with subtentorial lesions has not been established. Case Report We report herein a patient with supra- and subtentorial brain abscesses causedby L. monocytogenes infection. These abscesses did not respond to antibiotics, and his symptoms gradually worsened. Drainage was not indicated for subtentorial lesions, and the patientwas 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 suggestthat hyperbaric oxygen therapy is a good option for treating patients with deep-seated listerialabscesses and for who surgical drainage is not indicated.
Abstract
Background Listeria monocytogenes (L. monocytogenes) is a rare causative pathogen ofbrain abscess that is often found in immunocompromised patients. Although patients with supratentorial listerial abscesses showed a longer survival with surgical drainage, the standardtherapy for patients with subtentorial lesions has not been established. Case Report We report herein a patient with supra- and subtentorial brain abscesses causedby L. monocytogenes infection. These abscesses did not respond to antibiotics, and his symptoms gradually worsened. Drainage was not indicated for subtentorial lesions, and the patientwas 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 suggestthat hyperbaric oxygen therapy is a good option for treating patients with deep-seated listerialabscesses and for who surgical drainage is not indicated.
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