Case report: Cryptogenic giant brain abscess caused by Providencia rettgeri mimicking stroke and tumor in a patient with impaired immunity

Zhao, Yu1,2; Lian, Baorong3; Liu, Xudong4; Wang, Qizheng1,2; Zhang, Daxue5; Sheng, Qi1,2; Cao, Liming5

2022-09-23

10.3389/fneur.2022.1007435

Frontiers in Neurology   Impact Factor & Quartile

1664-2295

The highly lethal cryptogenic brain abscess can be easily misdiagnosed. However, cryptogenic brain abscess caused by Providencia rettgeri is rarely reported. We present the case of a cryptogenic Providencia rettgeri brain abscess and analyze the clinical manifestations, imaging findings, treatment, and outcome to improve the level of awareness, aid in accurate diagnosis, and highlight effective clinical management. A 39-year-old man was admitted to the hospital after experiencing acute speech and consciousness disorder for 1 day. The patient had a medical history of nephrotic syndrome and membranous nephropathy requiring immunosuppressant therapy. Magnetic resonance imaging revealed giant, space-occupying lesions involving the brain stem, basal ganglia, and temporal-parietal lobes without typical ring enhancement, mimicking a tumor. Initial antibiotic treatment was ineffective. Afterward, pathogen detection in cerebrospinal fluid using metagenomic next-generation sequencing revealed Providencia rettgeri. Intravenous maximum-dose ampicillin was administered for 5 weeks, and the patient's symptoms resolved. Cryptogenic Providencia rettgeri brain abscess typically occurs in patients with impaired immunity. Our patient exhibited a sudden onset with non-typical neuroimaging findings, requiring differentiation of the lesion from stroke and brain tumor. Metagenomic next-generation sequencing was important in identifying the pathogen. Rapid diagnosis and appropriate use of antibiotics were key to obtaining a favorable outcome.

Providencia rettgeri cryptogenic brain abscess impaired immunity metagenomic next-generation sequencing stroke-like onset brain tumor case report

SCI

English

Others

[20223357021]

Neurosciences & Neurology

Clinical Neurology ; Neurosciences

WOS:000864936800001

FRONTIERS MEDIA SA

Web of Science

1.Shenzhen Third Peoples Hosp, Dept Neurol, Shenzhen, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 2, Dept Neurol, Shenzhen, Peoples R China
3.Shantou Univ, Shantou Univ Med Coll, Shantou, Peoples R China
4.Shenzhen Univ, Dept Neurol, Affiliated Hosp 1, Shenzhen, Peoples R China
5.Anhui Med Univ, Sch Nursing, Hefei, Peoples R China

Zhao, Yu,Lian, Baorong,Liu, Xudong,et al. Case report: Cryptogenic giant brain abscess caused by Providencia rettgeri mimicking stroke and tumor in a patient with impaired immunity[J]. Frontiers in Neurology,2022,13.

Zhao, Yu.,Lian, Baorong.,Liu, Xudong.,Wang, Qizheng.,Zhang, Daxue.,...&Cao, Liming.(2022).Case report: Cryptogenic giant brain abscess caused by Providencia rettgeri mimicking stroke and tumor in a patient with impaired immunity.Frontiers in Neurology,13.

Zhao, Yu,et al."Case report: Cryptogenic giant brain abscess caused by Providencia rettgeri mimicking stroke and tumor in a patient with impaired immunity".Frontiers in Neurology 13(2022).