[Successful treatment of brain stem and thalamic abscesses with high-dose meropenem].
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| Abstract |
The incidence of brain abscess remains high, despite the development of novel antibiotics. Vancomycin or carbapenems, which are third-generation cephems, are recommended as standard therapy for bacterial meningitis or brain abscess. The effectiveness of the high-dose meropenem therapy on brain abscess has occasionally been reported. We experienced 2 consecutive cases of brain abscess in adults. The first patient was a 67-year-old man with diplopia, dizziness, and dysesthesia on the left upper and lower extremities. Images of T1-weighted magnetic resonance imaging (MRI) with contrast medium and diffusion-weighted MRI showed a ring enhancing cystic lesion and a high intensity lesion, respectively, in the right pons. The second patient was a 37-year-old man who complained of right hemiparesis. MRI revealed a ring-enhancing cystic mass in the left thalamus. On the basis of MRI findings, patients were diagnosed with brain abscess and were given high-dose meropenem (6g/day) continuously for 2 months. The abscess resolved completely after treatment with meropenem administered intravenously. Further, neurological deficits caused by abscess successfully improved. High-dose meropenem therapy should be considered as an effective treatment for brain abscess, even in the brain stem and basal ganglia, where it is quite difficult to achieve surgical access.
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| Authors | Toshihide Tanaka, Hiroki Sakamoto, Naoki Kato, Takao Arai, Yuzuru Hasegawa |
| Journal | Brain and nerve = Shinkei kenkyu no shinpo (Brain Nerve) Vol. 63 Issue 8 Pg. 891-6 (Aug 2011) ISSN: 1881-6096 [Print] Japan |
| PMID | 21817181 (Publication Type: Case Reports, Journal Article) |
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