ABSTRACT
INTRODUCTION: Bacillus cereus is a ubiquitous pathogen that usually produces self-limiting gastrointestinal symptoms. However, in susceptible patients, it can lead to central nervous system infections which are potentially fatal. DEVELOPMENT: We present the case of a 10-year-old male under chemotherapy treatment for acute lymphoblastic leukemia. During the induction period he developed a brain abscess due to B. cereus which was diagnosed through imaging tests and direct detection in the cerebrospinal fluid. His evolution was favorable with antibiotic treatment. CONCLUSIONS: So far, 26 other cases of central nervous system infections due to B. cereus have been described in literature, and besides being infrequent, they are a diagnostic challenge. However, in preterm infants, patients with hematological malignancies or central nervous system surgery, early suspicion should be established to start an appropriate antibiotic treatment and improve prognosis.
TITLE: Infección del sistema nervioso central por Bacillus cereus: descripción de un caso y revisión de la bibliografía.Introducción. Bacillus cereus es un patógeno ubicuo que, habitualmente, produce síntomas gastrointestinales autolimitados. Sin embargo, en pacientes susceptibles, puede dar lugar a infecciones del sistema nervioso central potencialmente mortales. Desarrollo. Presentamos el caso de un varón de 10 años en tratamiento quimioterápico por leucemia linfoblástica aguda. Durante el período de inducción desarrolló un absceso cerebral por B. cereus que fue diagnosticado mediante pruebas de imagen y detección directa en el líquido cefalorraquídeo. Su evolución fue favorable con tratamiento antibiótico. Conclusiones. Hasta ahora se han descrito en la bibliografía otros 26 casos de infección del sistema nervioso central por B. cereus, que, además de ser infrecuentes, suponen un reto diagnóstico. Sin embargo, en los recién nacidos prematuros, en pacientes con neoplasias hematológicas o con antecedentes de cirugía del sistema nervioso central, debe establecerse una sospecha temprana para iniciar un tratamiento antibiótico adecuado que mejore el pronóstico.
Subject(s)
Brain Abscess , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Anti-Bacterial Agents/therapeutic use , Bacillus cereus , Brain Abscess/diagnostic imaging , Brain Abscess/drug therapy , Child , Humans , Infant, Premature , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapyABSTRACT
Introducción: Bacillus cereus es un patógeno ubicuo que, habitualmente, produce síntomas gastrointestinales autolimitados. Sin embargo, en pacientes susceptibles, puede dar lugar a infecciones del sistema nervioso central potencialmente mortales. Desarrollo: Presentamos el caso de un varón de 10 años en tratamiento quimioterápico por leucemia linfoblástica aguda. Durante el período de inducción desarrolló un absceso cerebral por B. cereus que fue diagnosticado mediante pruebas de imagen y detección directa en el líquido cefalorraquídeo. Su evolución fue favorable con tratamiento antibiótico. Conclusiones: Hasta ahora se han descrito en la bibliografía otros 26 casos de infección del sistema nervioso central por B. cereus, que, además de ser infrecuentes, suponen un reto diagnóstico. Sin embargo, en los recién nacidos prematuros, en pacientes con neoplasias hematológicas o con antecedentes de cirugía del sistema nervioso central, debe establecerse una sospecha temprana para iniciar un tratamiento antibiótico adecuado que mejore el pronóstico.(AU)
Introduction: Bacillus cereus is a ubiquitous pathogen that usually produces self-limiting gastrointestinal symptoms. However, in susceptible patients, it can lead to central nervous system infections which are potentially fatal. Development: We present the case of a 10-year-old male under chemotherapy treatment for acute lymphoblastic leukemia. During the induction period he developed a brain abscess due to B. cereus which was diagnosed through imaging tests and direct detection in the cerebrospinal fluid. His evolution was favorable with antibiotic treatment. Conclusions: So far, 26 other cases of central nervous system infections due to B. cereus have been described in literature, and besides being infrequent, they are a diagnostic challenge. However, in preterm infants, patients with hematological malignancies or central nervous system surgery, early suspicion should be established to start an appropriate antibiotic treatment and improve prognosis.(AU)
Subject(s)
Humans , Male , Child , Inpatients , Physical Examination , Central Nervous System , Bacillus cereus , Infections , Abscess , Hematologic Neoplasms , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Neurology , Nervous System Diseases , Critical CareABSTRACT
Q fever is a zoonosis with a worldwide distribution caused by Coxiella burneti. Acute manifestations include a self-limited febrile illness which may associate headache, atypical pneumonia, or hepatitis. Neurological manifestations are rare, and they occur in less than half of the patients. Of these, approximately 1% present peripheral nervous system involvement, and, when present, it is difficult to diagnose because it has multiple manifestations such as mononeuritis multiplex, plexopathy or Guillain Barre syndrome. Due to the high rate of neurological sequelae, early diagnostic suspicion and appropriate treatment must be established. In this review, we have collected the patients with peripheral nervous system involvement due to Coxiella burnetii described so far. Our aim is to provide a concise description of the disease, its diagnosis and management that may be useful to clinicians treating such patients.
Subject(s)
Peripheral Nervous System/physiopathology , Q Fever/diagnosis , Coxiella burnetii , Guillain-Barre Syndrome/complications , Headache/complications , HumansABSTRACT
Influenza virus-associated encephalopathy/encephalitis is a rare entity in adults that can lead to severe neurological sequelae and even death. The clinical presentation can be quite diverse. This absence of a typical presentation along with the difficulty detecting the virus in the cerebrospinal fluid represents a diagnostic challenge. We present the case of a 79-year-old male with sudden onset of decreased consciousness and signs of right hemisphere damage. The presence of influenza A (H3N2) virus in respiratory sample along with compatible findings in cranial magnetic resonance led to the diagnosis. The patient died without responding to treatment with antivirals and immunomodulators and the anatomopathological study did not detect infectious agent. Early diagnostic suspicion is essential to establish adequate treatment and improve the prognosis.
Subject(s)
Cerebral Cortex/diagnostic imaging , Encephalitis, Viral/diagnostic imaging , Influenza A Virus, H3N2 Subtype/isolation & purification , Influenza, Human/diagnostic imaging , Aged , Cerebral Cortex/virology , Humans , Magnetic Resonance Imaging , MaleABSTRACT
Frontotemporal dementia (FTD) is a heterogeneous syndrome characterized by the progressive damage of frontal and temporal brain regions. These networks largely overlap with those involved in pain and temperature processing. Although the impaired perception of pain and temperature has been previously described to be relatively common in patients with FTD, these symptoms are often not consistently assessed by Neurologists. We present the case of a patient with a probable behavioral variant FTD who died due to scalding with hot water in the shower. Impairments in the perception of pain and temperature might have played a fundamental role in this accident.
