Postoperative Brain Abscess Caused by Co-Infection of Aspergillus and Staphylococcus: Case Report

ABSTRACT

A staphylococcal brain abscess admixed with aspergillosis occurred after operation for the olfactory groove meningioma at remote site. We report the rare case and consider the clinical pathogenesis. Bifrontal craniotomy for the olfactory groove meningioma was done in a 61-year-old female. She was bedridden for one month after craniotomy. During that period, panhypopituitarism occurred and was corrected with hormonal replacement. Sore in the occipital scalp which had occurred during the bedridden state was cared by dressing. After 60 days of treatment, he was discharged with ambulatory status. During postoperative period, we found left parieto-occipital brain abscess in the brain computed tomography(CT) at 3 months. And then craniotomy and abscess resection was performed. Vancomycin and itraconazole antibiotic therapy was instituted after the identification of staphylococcus and aspergillus in the cystic fluid, and aspergillus hyphae in the solid wall portion of the abscess. After the confirmation of resolution of brain abscess on the postoperative 3 weeks' brain CT, the patient was discharged with oral itraconazole medication.