From Lungs to Brain: An Uncommon Brain Abscess Following Pneumonia

Narjes  Hamidi; Atiyeh Sadat  Sajadi; Narges  Borhani; Mohammad Niakan  Lahiji; Mahnaz Faramarzi  Keneshti

doi:10.18502/aacc.v12i2.20962

Narjes Hamidi Department of Anesthesia, Faculty of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.
Atiyeh Sadat Sajadi Department of Anesthesia, Faculty of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.
Narges Borhani Department of Anesthesia, Faculty of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.
Mohammad Niakan Lahiji Department of Anesthesiology and Critical Care, School of Medicine, Iran Univesity of Medical Science, Tehran, Iran.
Mahnaz Faramarzi Keneshti Department of Operation Room, Shahriyar Social Security Hospital, Social Security Organization, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v12i2.20962

Keywords: Brain abscess; Pneumonia; Epididymitis

Abstract

A 37-year-old male with no significant medical history presented to the hospital following a fall into a pit containing animal feces, resulting in aspiration pneumonia. He was intubated and treated with antibiotics, and after 15 days of hospitalization, he was discharged in stable condition. Four days later, he returned with scrotal pain and swelling, diagnosed as epididymitis, and successfully treated with ceftriaxone. On September 1st, he re-presented with headache, dizziness, and malaise, and imaging revealed a brain abscess. Despite undergoing stereotactic surgery, the patient experienced persistent neurological symptoms, including fluctuating consciousness, nausea, and vomiting. He subsequently developed hydrocephalus, necessitating the placement of an external ventricular drain and transfer to the ICU. The patient was treated with antifungal and antibiotic therapies, but his clinical condition deteriorated. Despite intensive care, he succumbed to his illness after 19 days in the ICU.