Sudden death from rupture of cerebral abscess into subarachnoid space

A Mexican man in his mid-30s with a medical history of atrial septal defect presented with sudden onset of left lower extremity weakness and a 2-week history of fever, headache and purulent rhinorrhoea. Given no significant worsening of mass effect, herniation or evidence of rupture of abscess into...

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Bibliographic Details
Published in:BMJ case reports 2018-12, Vol.11 (1), p.e226743
Main Authors: Curran, Courtney, Nakhasi, Ambica, Prochilo, Gina, Kavi, Tapan
Format: Article
Language:English
Subjects:
Abscesses
Adult
Brain Abscess - complications
Brain Abscess - diagnostic imaging
Brain Abscess - pathology
Brain Death
Case reports
Cysts
Death, Sudden - etiology
Edema
Gram-Negative Bacterial Infections - complications
Gram-Negative Bacterial Infections - diagnosis
Gram-Negative Bacterial Infections - pathology
Gram-Positive Bacterial Infections - complications
Gram-Positive Bacterial Infections - diagnosis
Gram-Positive Bacterial Infections - pathology
Heart Septal Defects, Atrial - complications
Humans
Images In
Infections
Male
Mortality
Neuroimaging
Neurology
Rupture, Spontaneous
Sinusitis - complications
Subarachnoid Space - pathology
Tomography, X-Ray Computed
Veins & arteries
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Summary:A Mexican man in his mid-30s with a medical history of atrial septal defect presented with sudden onset of left lower extremity weakness and a 2-week history of fever, headache and purulent rhinorrhoea. Given no significant worsening of mass effect, herniation or evidence of rupture of abscess into intraventricular space, rupture of abscess into subarachnoid space was considered the cause of sudden deterioration and brain death. Little is known about what increases the risk for rupture into the subarachnoid space, but multiloculation and close proximity to the ventricles increase the risk for intraventricular rupture.3 It is important to be aware of this complication, as it underlines the importance of early medical and surgical management of cerebral abscess.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-226743