One case of sinus-communicating brain abscess caused by Acinetobacter lwoffii-induced infectious multiple sinusitis of the paranasal sinuses

WANG Bang-xiang; QIN De-fang; HUO Yong-lin; ZHANG Ze-shun; MA Ding

doi:10.13798/j.issn.1009-153X.2024.04.015

Abstract：Brain abscesses are most often caused by the spread of infection from neighbouring tissues.Fusobacterium lophi is an aerobic Gram-negative bacillus that colonizes the oropharnx,skin,and perineum,and is an opportunistic pathogen that causes damage to the immune system and leads to infection when the body is immunocompromised.It is rare for Fusobacterium lophi to cause a sinus-communicating brain abscess.This paper reports a case of sinus-communicating brain abscess secondary to Fusobacterium lophi infectous multiple sinusitis,a 24-year-old male,who was admitted to our hospital because of sudden headache for half a month,and there were no abnormalities in blood routine,serum CRP and PCT.Cerebrospinal fluid routine,biochemistry,bacterial and fungal culture showed no abnormality.Head CT and MRI considered multiple abscesses in the left frontal lobe,cysts in the left maxillary sinus and right pterygoid sinus.Cerebrospinal fluid pathogenic microorganism test shwoed Lofibacillus.Vancomucin,meropenem,and ornidazole were given for 1 week,and head CT showed a decrease in intracranial hypodense foci.After perfecting the preoperative preparations,endonasal endoscopic resection of the left sinus lesion,and incision of left maxillary sinus,sieve sinus and frontal lobe wer performed.One month after the operation,head CT and enhanced MRI showed that the multiple brain abscesses in the left frontal lobe were absorbed.The headache improved significantly 3 months after the operation.This suggests that when a brain abscess is suspected,CTand MRI should be performed to clarify the diagnosis,and emprical antibiotic traeatment should be given.When the culture can not find the pathogenic bacteria,genetic testing can be used to increase the detection rate.