Salmonella Typhimurium Brain Abscess in an Immunocompetent Adult with a Spontaneous Intracerebral Hemorrhage: A Case Report

Corresponding author: Jung Soo Park Department of Neurosurgery, Chonbuk National University Hospital, Chonbuk National University, 20, Geonjiro Deokjin-gu, Jeonju 54907, Republic of Korea Tel: +82-63-250-1870 Fax: +82-63-277-3273 E-mail: rollingstone12@hanmail.net A brain abscess caused by Salmonella typhimurium (S. typhimurium) in an immunocompetent adult is rare. We report a case of brain abscess caused by S. typhimurium in a 46-year-old male and a brief review of the literature. The patient visited a local hospital because of right hemiparesis. Brain computed tomography and magnetic resonance imaging results showed an acute hematoma in the left basal ganglia. After 3 weeks of conservative therapy, the patient was transferred to our hospital due to uncontrolled fever, aphasia, and aggravated motor weakness. Contrast-enhanced computed tomography showed a rim-enhanced cystic mass with peripheral edema, prompting trephination to drain the cystic fluid. The drained fluid was yellowish-mucoid, similar to a pus. Specimens from the drained fluid and urine S. typhimurium were cultured and microbiologically analyzed. We administered ceftazidime 2,000 mg and vancomycin 2,000 mg/day for 6 weeks intravenously and changed ceftriaxone 2,000 mg/day for an additional 3 weeks due to a drug eruption. The patient recovered with no neurological deficits. Surgical drainage of the intracranial abscess and prolonged sensitive antibiotic therapy is essential to obtain positive results.

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