Double cerebral abscess with Stenotrophomonas Maltophilia secondary to pulmonary abscess and with septic sigmoid sinus and jugular vein thrombosis

Abstract

The patient, 35 years old, left-handed, admitted for mixed aphasia, left hemiparesis, temporal-spatial disorientation, later stupor, symptoms appeared for about 24 hours and progressively intensified. Cranial CT scan with contrast and lung with contrast revealed 2 brain abscesses, one large frontal abscess on the right (54/51/47 mm) extended subcortically to the wall of the lateral ventricle and right parietal (32/26/22 mm). Right mediobasal corticalized lung abscess 47/51/28 mm. Toraco-pulmonary CT scan revealed millimetric pulmonary microlesions (some calcified), predominantly in the right upper lobe and a right parietal abscess 47/51/28 mm. The patient underwent emergency surgery (Right frontal craniotomy, subtotal excision of the abscess under magnification, right parietal craniotomy, excision of the abscess under magnification). Along with the surgical treatment, antibiotic treatment was administered according to the antibiogram administered iv and in aerosols, neurotropics, Vitamins B1, B6, anticoagulant treatment for venous thrombosis.