Drastic Therapy for Listerial Brain Abscess Involving Combined Hyperbaric Oxygen Therapy and Antimicrobial Agents

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.

Results of questionnaire surveys of medical doctors of two groups regarding self-management of assessed personal problems in health information records. - Who will create and assess patients' problem lists? - / 日本プライマリ・ケア連合学会誌

<b>Purpose</b> : To seek opinions of medical doctors regarding self-management of assessed personal problems in health information records (SAPPHIRE) by patients themselves. <br><b>Methods</b> : Ten-item questionnaires regarding SAPPHIRE were sent to each of two groups of medical doctors, using regular mail for A) doctors of private clinics, and hand-delivered to B) doctors working in a large hospital. <br><b>Results</b> : Of the responding 292 medical doctors, 72.9% were in favor of using SAPPHIRE. More medical doctors of private clinics indicated preference for recording and assessment by a medical doctor (47.4%) than doctors working in a large hospital (25.2%). On average, responding medical doctors answered that problem lists could be recorded by co-medical staff (44.1%), but in the end, need to be created with the trustworthy assessment of a medical doctor (79.7%). <br><b>Conclusion</b> : More than 70% of medical doctors responded in favor of using SAPPHIRE. Patients' reliable problem lists could be recorded by co-medical staff or a medical doctor, but need to be created with the trustworthy assessment of a medical doctor.