Brain Abscess Research Articles

Ten-year statewide cross-sectional review of pediatric sinogenic intracranial abscess and empyema in Queensland, Australia: microbial profile before and after COVID-19.

Sinogenic intracranial infections in children, such as subdural empyema or intracranial abscess, are a rare disease process with significant associated morbidity. Recent literature has suggested that there may have been an increase in frequency of these infections following the COVID-19 pandemic, but the literature has been conflicting, perhaps related to the heterogenous management of COVID-19 lockdowns in various states and differences in data capture between methods. The collection of statewide Australian data overcomes these limitations by capturing a comprehensive sample though the public healthcare system of patients who were subject to a homogeneous statewide approach to public health policy during the COVID-19 pandemic (population 5.6 million, including 1.3 million children). The objective of this study was to present population-level data to address the question of whether the incidence of intracranial infections changed in pediatric patients before and after the COVID-19 pandemic. The authors present a retrospective 10-year statewide description of sinogenic intracranial infections in Queensland, Australia. A comparison was made between the incidence and microbiological profile before and after the onset of COVID-19 lockdowns on March 22, 2020. Forty-four pediatric intracranial infections undergoing neurosurgical intervention were identified within the review period. After exclusion of postsurgical and cardioembolic causes, 33 sinogenic intracranial infections were included (16 before and 17 after 2020, with a mean annualized incidence of 0.25 vs 0.37 cases per 100,000 children, respectively; p > 0.05). The most frequent organisms identified were Streptococcus milleri (n = 19), polymicrobial (n = 4), and S. aureus (n = 3). No significant differences in antimicrobial profile, susceptibility, parenchymal involvement, or clinical outcome were identified between the pre- and post-COVID-19 groups. No statistically significant differences in the epidemiology of pediatric intracranial infection have occurred in the state of Queensland, Australia, before and after March 22, 2020, and the COVID-19 pandemic.

Undetected permanent dental inflammation as a possible trigger for brain abscesses? A retrospective analysis over the last 2 decades

BackgroundRecently, there is increasing evidence that the proportion of odontogenic brain abscesses is greater than previously known. In this study, we aim to differentiate the oral infections as triggers more precisely and to classify them in the clinical setting.MethodsFor analysis, we conducted a retrospective single center study. We reviewed patients with brain abscesses who have undergone treatment in the University Hospital of Freiburg, Germany in the period between 2000–2021. Inclusion required two main criteria: 1. The brain abscess must not have an other focus than odontogenic. 2. The microbial spectrum identified in the brain abscess must be consistent with an odontogenic origin.ResultsOf 217 brain abscess patients, 26 met the inclusion criteria. 42% (11 patients) suffered from immunosuppressive conditions. Odontogenic foci were diagnosed in 18 cases (69%). Neurologic deficits included vigilance reduction and hemiparesis. Pathogens of the Streptococcus anginosus group were the most frequent causative agent (21 cases, 81%). Metronidazole (54%) and ceftriaxone (42%) were part of the targeted antibiotic therapy. All brain abscesses were surgically treated. Teeth were extracted in 14 of 17 cases for focus control. 18 cases (72%) showed complete or partial resolution of neurologic symptoms and 3 cases were fatal.ConclusionApparently silent or chronic oral infections are sufficient to cause bacterial colonization of the brain, especially in immunocompromised patients. Therefore, special care should be taken to maintain good oral health. An interdisciplinary management should become a standard to prevent and treat the occurrence of brain abscesses.

A case of pediatric brain abscess secondary to rhinosinusitis

Acute bacterial rhinosinusitis is a common childhood infection and a frequent complication of viral infections or allergic inflammations of the upper respiratory tract. Untreated cases may have serious complications as meningitis, orbital cellulitis, epidural and brain abscesses (1,2). Brain abscesses rarely seen pediatric infections with high mortality and morbidity rates, are mostly observed secondary to extrasinus spread of rhinosinusitis and acute otitis media, hematogenous spread and penetrating trauma (3). The most common predisposing factors are immunodeficiencies, cyanotic heart and hematologic diseases. A 16-year-old boy was admitted to the emergency service due to seizure. It was learned from his history that he was admitted to the hospital 10 days ago due to headache and high fever. With the diagnosis of acute sinusitis, azithromycin and ornidazole treatment was started, but there was no improvement in his complaints.. On physical examination, clouding of consciousness and postnasal purulent discharge were detected. Remarkable laboratory test results: WBC: 22.500/mm3; platelets 156.000/mm3, C-reactive protein 226 mg/L. Brain tomography revealed a 4-cm suspicious abscess or mass lesion in the right frontal region of the brain compatible with right frontal and ethmoid sinusitis. Upon consultation with pediatric neurology and neurosurgery departments, cranial MRI and MR spectrometry were performed which revealed a lesion compatible with a 4- cm brain abscess, brain edema , shift, and acute sinusitis in the right frontal region. Treatment with cefotaxime, vancomycin and metroinidazole was started for acute sinusitis, and hypertonic sodium infusion and leveteresitam treatment for brain edema. Surgical drainage of the abscess > 2 cm was performed by neurosurgery. Gram staining and culture of the abscess material were unremarkable. Upon evaluation by pediatric immunology, cardiology and hematology departments, immunodeficiency, cyanotic heart disease and hematologic disease were not detected. The lesion was evaluated as inappropriately treated brain abscess secondary to acute sinusitis. In the 2nd week of treatment, edema surrounding the abscess, shift and pressure regressed, but the the abscess did not shrink, so the treatment with meropenem, vancomycin and metroinidazole was initiated. Antiedema therapy was discontinued, and antibiotherapy was maintained for 9 weeks until the abscess size was < 2 cm. When the abscess shrinked below 1 cm in the control cranial images he was discharged with follow-up recommendations. Acute bacterial sinusitis is one of the common, and clinically diagnosed infectious diseases of childhood. And current guidelines recommend amoxicillin, amoxicillin-clavulanic acid and cephalosporins (ie.cefdinir) as the first-line treatment. Considering the high drug resistance in our country, macrolides are not the first choice in patients without a history of penicillin allergy (2). If not treated appropriately, serious cranial complications preventable with timely appropriate antibiotherapy may develop. Brain abscesses are rare but mortal infectious diseases in childhood. The most common cause is the extrasinus spread of infections such as acute rhinosinusitis (3). Combination of medical and surgical treatment is usually recommended for abscesses > 2 cm. For abscesses < 2 cm and inoperable multiple abscesses only medical treatment is an option. Although the duration of treatment depends on the size, location, causative agent and treatment response, medical treatment is recommended for approximately 6-12 weeks until the abscess is < 2 cm (4)

Diffusion kurtosis imaging for different brain masses characterization

BackgroundDiffusion kurtosis imaging is an advanced magnetic resonance imaging technique that reveals additional information on the microstructure and micro-dynamics of different brain masses without the need for contrast agents. The aim of this study was to provide a comprehensive analysis of the role of MRI diffusion kurtosis and to compare it with magnetic resonance spectroscopy (MRS) and dynamic susceptibility contrast perfusion (DSC) in characterizing different brain masses, including gliomas, recurrent tumors, radiation necrosis, abscesses, and infarctions. Sixty-six patients with intracranial brain masses were enrolled in this prospective study. All patients were examined by conventional MRI sequences, DSC perfusion, MRS, and diffusion kurtosis imaging, with implemented b values which were 200, 500, 1000, 1500 and 2000s/mm2.ResultsMean kurtosis (MK) was higher (P < 0.001) in recurrent brain tumors than in radiation-induced necrosis; the optimal MK cutoff value for differentiation between them was 642 with 91.3% sensitivity and 85.7% specificity. Mean kurtosis was also higher (P < 0.001) in high-grade gliomas than in low-grade gliomas; the optimal MK cutoff value for differentiation between them was 639 with 91.6% sensitivity and 85.71% specificity. There was a good level of agreement between ADC and MD within the studied cases, with a correlation coefficient r = 0.815. MK had more sensitivity and specificity in differentiation between high- and low-grade gliomas, as well as RIN and tumoral recurrence, than MRS and DSC.ConclusionsDiffusion kurtosis imaging stands as an integral, noninvasive, and noncontrast tool for the characterization of various brain masses. It augments the capabilities of traditional and advanced MRI techniques, providing a deeper understanding of the microstructural changes in brain tissues.

Multiple brain abscesses caused by Nocardia farcinica infection after hand injury: A case report and literature review.

Nocardia infection is commonly regarded as an opportunistic pulmonary pathogen affecting debilitated or immunocompromised individuals. Brain abscesses caused by Nocardia farcinica are rare and pose a diagnostic challenge. Traditional diagnostic techniques for identifying Nocardia species, such as blood culture, microscopy, and pathology, have shown inadequate performance. In the reported case, we applied metagenomic next-generation sequencing (mNGS) to diagnose a case of brain abscess due to N. farcinica. A 66-year-old female developed a brain abscess after sustaining a hand injury. The patient exhibited a gradual change in personality and experienced tremors in her right upper limb for a duration of 1 month. The pathogen responsible for the multiple brain abscesses was identified in the cerebrospinal fluid as N. farcinica through mNGS. Antibiotic treatment included trimethoprim-sulfamethoxazole, linezolid, amikacin, meropenem, and moxifloxacin. The patient's symptoms and signs improved significantly after administration of antibiotics to which the pathogen is known to be sensitive. After 5 months of follow-up, magnetic resonance imaging of the head showed that the abscess was basically cured. The patient lived a normal life with no adverse drug reactions. Nocardia brain infection is characterized by an insidious onset and lacks distinctive clinical and imaging features. mNGS was advantageous for the timely identification and management of Nocardia-associated brain abscess in the present case and obviated the need for invasive brain surgery. Expeditious and precise diagnosis coupled with prompt antibiotic therapy can significantly reduce the mortality rate associated with this condition.

Metronidazole-induced encephalopathy

A 27-year-old male with a long-standing history of chronic otitis media developed a right temporal cerebral abscess. He underwent a mastoidectomy and was treated with intravenous antibiotics, including metronidazole. The patient’s clinical condition showed signs of improvement.

Fosfomycin-Containing Regimens for the Treatment of Central Nervous System Infections in a Neonatal Intensive Care Unit: A Case Series Study.

Central nervous system infections are among the most severe infectious conditions in the neonatal period and are still burdened by significant mortality, especially in preterm infants and those with a low birth weight or other comorbidities. In this study, we examined the role of fosfomycin-containing antibiotic regimens in neonates with central nervous system infections. We included six neonates over a period of five years: four with meningitis and two with cerebral abscesses. All patients underwent fosfomycin therapy after failing first-line antibiotic regimens. Of the six neonates, two died; two developed neurological and psychomotor deficits and two recovered uneventfully. None of the neonates experienced adverse reactions to fosfomycin, confirming the safety of the molecule in this population. In conclusion, the deep penetration in the central nervous system, the unique mechanism of action, the synergy with other antibiotic therapies, and the excellent safety profile all make fosfomycin an attractive drug for the treatment of neonatal central nervous system infections.

Intracranial dissemination of Klebsiella pneumoniae originating from pulmonary infection: a case report

BackgroundMetastatic brain abscesses caused by Klebsiella pneumoniae are extremely rare but life-threatening conditions. To depict a unique case of the middle-aged hypertensive man with an unusual presentation of metastatic brain abscesses originating from a pleural abscess caused by Klebsiella pneumoniae and subsequently leading to loss of consciousness (LOC).Case reportA 52-year-old Iranian man with a history of hypertension presented to the emergency department with a five-day history of worsening cough, high-grade fever, shortness of breath, chest pain, fatigue, and a productive cough. Laboratory tests revealed leukocytosis, elevated C-reactive protein, and respiratory alkalosis. A chest computed tomography scan confirmed pneumonia, and a brain scan revealed multiple hypodense lesions. Despite antibiotic therapy, the patient's condition worsened, leading to confusion, disorientation, and loss of consciousness. Magnetic resonance imaging revealed multiple ring-enhancing lesions, suggesting an abscess formation. Bronchial washings and BAL samples confirmed a lower respiratory tract infection. Cultures from the bronchial washings grew Klebsiella pneumoniae.ConclusionsMetastatic brain abscesses caused by Klebsiella pneumoniae are exceedingly rare but life-threatening conditions. Timely diagnosis and effective antimicrobial treatment are critical for patient outcomes. This case underscores the significance of recognizing atypical presentations of bacterial infections, as early detection and appropriate management can significantly impact patient outcomes.

Brain Abscesses in Domestic Ruminants: Clinicopathological and Bacteriological Approaches.

Brain abscesses in ruminants often arise from primary infection foci, leading to an unfavorable prognosis for affected animals. This highlights the need for comprehensive studies on brain abscesses across different ruminant species. We retrospectively investigated medical records of epidemiological, clinical, neuroimaging, anatomopathological, and bacteriological findings in six ruminants (three goats, two cows, and one sheep) diagnosed with brain abscesses. All animals studied were female. Apathy (50%), compulsive walking (33%), decreased facial sensitivity (33%), head pressing (33%), seizures (33%), semicomatous mental status (33%), strabismus (33%), unilateral blindness (33%), and circling (33%) represented the most common neurologic signs. Leukocytosis and neutrophilia were the main findings in the hematological evaluation. Cerebrospinal fluid (CSF) analysis revealed predominant hyperproteinorrachia and pleocytosis. In three cases, computed tomography or magnetic resonance imaging were used, enabling the identification of typical abscess lesions, which were subsequently confirmed during postmortem examination. Microbiological culture of the abscess samples and/or CSF revealed bacterial coinfections in most cases. Advanced imaging examinations, combined with CSF analysis, can aid in diagnosis, although confirmation typically relies on postmortem evaluation and isolation of the causative agent. This study contributes to clinicopathological aspects, neuroimages, and bacteriological diagnosis of brain abscesses in domestic ruminants.

Venous Hemorrhagic Infarct Leading to Delayed Brain Abscess Formation: A Case Report

AbstractVenous sinus thrombosis is a common neurovascular problem with multifactorial etiology, infection being one of the common causes. Cerebral abscess causing thrombophlebitis and venous sinus occlusion is a known entity. In contrast, venous hemorrhagic infarct leading to abscess formation is extremely uncommon. We report a rare case of such delayed abscess formation in a venous hemorrhagic infarct secondary to superior sagittal sinus occlusion.

Supraorbital Approaches for Anterior Skull Base and Parasellar Lesions: Insights From a Single-Center Experience.

Modern neurosurgery has undergone significant evolution to include minimally invasive procedures, with the supraorbital approach (SOA) being a prime example. In this study, we aim to explore the surgical techniques and outcomes of this approach in the surgical treatment of frontal lobe, anterior skull base, and parasellar lesions. This study included 33 patients aged 36-83 years who underwent surgery using the SOA for lesions in the inferior frontal lobe, anterior skull base, and parasellar area between 2015 and 2024. There were 25 cases of meningioma, 2 cases of brain abscess, 2 cases of glioma, and one case each of craniopharyngioma, hemangioma, metastasis, and Rathke's cleft cyst. The medical data and follow-up results were retrospectively analyzed. The mean size of lesion was 3.38±3.05 cm. The mean follow-up period was 48.8 months. Gross total resection was achieved in 25 patients (75.8%). There were no perioperative deaths, cases of cerebrospinal fluid rhinorrhea, or infections. Two cases of morbidity were reported as complications: one case of delayed intracerebral hemorrhage and one case of infarction due to vascular injury. All patients exhibited satisfactory cosmetic results. In comparison to the conventional pterional approach, the SOA represents a safe and effective keyhole method for the removal of both extra-axial and intra-axial skull base tumors. This is particularly beneficial for lesions in the orbitofrontal region and parasellar area, as it allows for minimal disruption of normal brain parenchyma. Moreover, the SOA promotes a swift recovery and short hospital stay. Additionally, the SOA yields superior cosmetic results, including the prevention of temporalis muscle atrophy.

Comparison of clinical outcomes of pulmonary nocardiosis between AIDS and non-AIDS patients

BackgroundNocardia species can affect both immunocompetent and immunocompromised people.MethodThis retrospective study, from 2009 to 2022, aims to compare the survival analyses of pulmonary nocardiosis in AIDS and non-AIDS patients in northeastern Thailand.ResultsA total of 215 culture-confirmed cases of pulmonary nocardiosis: 97 with AIDS and 118 without AIDS. The median CD4 count of AIDS patients was 11 cells/µL (range: 1–198), and 33% had concurrent opportunistic infections. 63.6% of 118 non-AIDS patients received immunosuppressive medications, 28.8% had comorbidities, and 7.6% had no coexisting conditions. Disseminated nocardiosis and pleural effusion were more prevalent among AIDS patients, whereas non-AIDS patients revealed more shock and respiratory failure. One hundred-fifty patients underwent brain imaging; 15 (10%) had brain abscesses. Patients with pulmonary nocardiosis have overall 30-day and 1-year mortality rates of 38.5% (95% CI: 32.3%, 45.4%) and 52.1% (95% CI: 45.6%, 58.9%), respectively. The Cox survival analysis showed that AIDS patients with disseminated nocardiosis had a 7.93-fold (95% CI: 2.61–24.02, p < 0.001) increased risk of death within 30 days compared to non-AIDS patients when considering variables such as age, Charlson comorbidity index, concurrent opportunistic infections, duration of illness, shock, respiratory failure, multi-lobar pneumonia, lung abscesses, and combination antibiotic therapy. While AIDS and pulmonary nocardiosis had a tendency to die within 30 days (2.09 (95% CI, 0.74–5.87, p = 0.162)).ConclusionAIDS with pulmonary nocardiosis, particularly disseminated disease, is a serious opportunistic infection. Early diagnosis and empiric treatment with a multidrug regimen may be the most appropriate approach in a resource-limited setting.

Diagnostic role of sonography in early detection and surgical intervention of an epidural abscess: A case report

AbstractIntroductionIntracranial epidural abscesses require swift diagnosis and treatment. While magnetic resonance imaging (MRI) is preferred for its detailed visualisation, it is costly and time‐consuming. Transcranial sonography offers a rapid, portable and cost‐effective alternative for assessing brain lesions.MethodsWe present a case study involving the diagnosis and management of an intracranial epidural abscess in a 25‐year‐old man with a traumatic brain injury who underwent a craniectomy and later developed fever and drowsiness in the intensive care unit.ResultsUsing transcranial point‐of‐care ultrasound, a hypoechoic collection was identified at the surgical site, prompting further imaging with computed tomography (CT) and MRI, which confirmed the diagnosis of an epidural abscess. Prompt surgical intervention led to the resolution of symptoms and a favourable clinical outcome.ConclusionThis case highlights the potential utility of brain sonography as an efficient and cost‐effective initial diagnostic tool for detecting intracranial complications, particularly in postoperative patients with altered sensorium and fever, where timely intervention is crucial.

Fever of unknown origin revealing testicular nocardiosis: a case report and literature review

BackgroundNocardia is an ubiquitous soil organism. As an opportunistic pathogen, inhalation and skin inoculation are the most common routes of infection. Lungs and skin are the most frequent sites of nocardiosis. Testis is a highly unusual location for nocardiosis.Case presentationWe report the case of an immunocompromised 75-year-old-man admitted for fever of unknown origin. He presented with skin lesions after gardening and was first suspected of Mediterranean spotted fever, but he did not respond to doxycycline. Then, physical examination revealed new left scrotal swelling that was compatible with a diagnosis of epididymo-orchitis. The patient’s condition did not improve despite empirical antibiotic treatment with the onset of necrotic scrotal abscesses requiring surgery. Nocardia brasiliensis yielded from the removed testis culture. High-dose trimethoprim-sulfamethoxazole and ceftriaxone were started. Multiple micro-abscesses were found in the brain and spinal cord on imaging studies. After 6 weeks of dual antibiotic therapy for disseminated nocardiosis, slight regression of the brain abscesses was observed. The patient was discharged after a 6-month course of antibiotics and remained relapse-free at that time of writing these lines. Trimethoprim-sulfamethoxazole alone is meant to be pursued for 6 months thereafter. We undertook a literature review on previously reported cases of genitourinary and urological nocardiosis; to date, only 36 cases have been published with predominately involvement of kidney, prostate and testis.ConclusionsTo the best of our knowledge, this is the first case of Nocardia brasiliensis simultaneously infecting skin, testis, brain and spinal cord in an immunocompromised patient. Knowledge on uncommon forms of nocardiosis remains scarce. This case report highlights the difficulty of diagnosing atypical nocardiosis and the importance of prompt bacteriological sampling in case of empirical antibiotics failure.

Brain abscess caused by Streptococcus anginosus group: Three case reports

BACKGROUND This case series investigated the clinical manifestations, diagnoses, and treatment of cerebral abscesses caused by Streptococcus anginosus . We retrospectively analyzed the clinical characteristics and outcomes of three cases of cerebral abscesses caused by Streptococcus anginosus and conducted a comprehensive review of relevant literature. CASE SUMMARY Case 1 presented with a history of left otitis media and exhibited high fever, confusion, and vomiting as primary symptoms. Postoperative pus culture indicated a brain abscess caused by Streptococcus constellatus infection. Case 2 experienced dizziness for two days as the primary symptom. Postoperative pus culture suggested an intermediate streptococcal brain abscess. Case 3: Enhanced head magnetic resonance imaging (MRI) and diffusion-weighted imaging revealed occupancy of the left temporal lobe, initially suspected to be a metastatic tumor. However, a postoperative pus culture confirmed the presence of a brain abscess caused by Streptococcus anginosus infection. The three cases presented in this case series were all patients with community-acquired brain abscesses resulting from angina caused by Streptococcus group infection. All three patients demonstrated sensitivity to penicillin, ceftriaxone, vancomycin, linezolid, chloramphenicol, and levofloxacin. Successful treatment was achieved through stereotaxic puncture, drainage, and ceftriaxone administration with a six -week course of antibiotics. CONCLUSION Preoperative enhanced head MRI plays a critical role in distinguishing brain tumors from abscesses. Selecting the correct early diagnostic methods for brain abscesses and providing timely intervention are very important. This case series was in accordance with the CARE guidelines.

Anesthesiologist’s Perspective on a Child with Acute Lymphoblastic Leukemia undergoing Neurosurgery: Case Report

Acute lymphoblastic leukemia (ALL) is the most common hematological malignancy in the pediatric age group. Anesthesia in such patients necessitates special considerations, in terms of disease progression and its respective treatment as well. We present a case of a 2-year-old child, a known case of ALL posted for drainage of multifocal brain abscess under general anesthesia. Anesthetic management of children with ALL presenting for neurosurgical procedures should focus on disease and its various systemic manifestations, treatment-related side effects, and anesthetic interactions which sometimes may be disastrous

Polymicrobial brain abscesses: A complex condition with diagnostic and therapeutic challenges.

Brain abscesses (BA) are focal parenchymal infections that remain life-threatening conditions. Polymicrobial BAs (PBAs) are complex coinfections of bacteria or bacterial and nonbacterial pathogens such as fungi or parasites, with diagnostic and therapeutic challenges. In this article, we comprehensively review the prevalence, pathogenesis, clinical manifestations, and microbiological, histopathological, and radiological features of PBAs, as well as treatment and prognosis. While PBAs and monomicrobial BAs have some similarities such as nonspecific clinical presentations, PBAs are more complex in their pathogenesis, pathological, and imaging presentations. The diagnostic challenges of PBAs include nonspecific imaging features at early stages and difficulties in identification of some pathogens by routine techniques without the use of molecular analysis. Imaging of late-stage PBAs demonstrates increased heterogeneity within lesions, which corresponds to variable histopathological features depending on the dominant pathogen-induced changes in different areas. This heterogeneity is particularly marked in cases of coinfections with nonbacterial pathogens such as Toxoplasma gondii. Therapeutic challenges in the management of PBAs include initial medical therapy for possibly underrecognized coinfections prior to identification of multiple pathogens and subsequent broad-spectrum antimicrobial therapy to eradicate identified pathogens. PBAs deserve more awareness to facilitate prompt and appropriate treatment.

Cerebral manifestation of hypervirulent klebsiella pneumoniae: An in-depth case report on isolated brain abscess

Cerebral manifestation of hypervirulent klebsiella pneumoniae: An in-depth case report on isolated brain abscess

The Importance of Early Physical Therapy Intervention in Fighting Post-surgical Sequelae in a Patient with Cerebral Abscess

The primary objective of this research was to highlight the importance of early physical therapy intervention in fighting neurological sequelae following surgical intervention and improving the patient's level of independence in cases of cerebral abscess. The study was based on identifying the degree of neuro-motor impairment immediately after the surgery, followed by establishing a specific physical therapy intervention strategy based on the identified manifestations. The subjects included in the study had a common clinical diagnosis of cerebral abscess and the presence of neurological sequelae post-surgery. The physical therapy approach consisted of neuro-proprioceptive facilitation techniques and methods, considered the most effective in such pathologies. The results obtained from the initial and final evaluations of the patients included in the study and their interpretationhighlighted that the early application of neuro-motor and proprioceptive facilitation techniques allowed achieving favorable results and reaching the proposed objectives.

A case of central nervous system infection with Scedosporium boydii

AbstractScedosporium boydii is considered an opportunist fungal pathogen in immunocompromised patients. It also causes serious and fatal central nervous system infections. In this study, a man with brain abscesses infected with S. boydii was diagnosed using multiple methods, including microscopy, culture combined with Matrix‐assisted laser desorption ionization time‐of‐flight mass spectrometry (MOLDI‐TOF MS), internal transcribed spacer sequencing and Metagenomic next‐generation sequencing (mNGS). This successful diagnosis highlights the importance of using a variety of techniques to identify and treat infections caused by this dangerous fungus.