Background: Brain abscesses are rare but serious infections caused by bacteria or fungi in the brain tissue. They can cause serious problems if not treated quickly, so it is important to find the problem and treat it as soon as possible.
Case Presentation: A 46-year-old Saudi male heavy smoker presented to the emergency department with a 3-day history of dry cough, sore throat, subjective fever, malaise, and generalized body pain. Three pneumonia hospitalizations and a bronchoscopy confused the patient upon admission. The patient had a Glasgow Coma Scale of 14/15 and a mild right pronator drift. Brain imaging showed bilateral frontal intra-axial space-occupying lesions. Escherichia coli and Staphylococcus aureus, sensitive to amoxicillin and clavulanic acid, grew together in culture. At 1-month follow-up, the patient had fully recovered. Peripheral enhancement reduced abscess cavity size on a repeat computed tomography-brain. The patient showed no neurological deficits at his 3- and 6-month clinic visits. Long-term antibiotics were recommended for 6 months.
Conclusion: A 46-year-old Saudi man with bilateral brain abscesses shows the importance of early diagnosis and treatment. Imaging and culture results helped diagnose and treat. Aspirating the cystic lesions and the patient’s recovery prove the treatment’s efficacy.
Key words: Neurological infections, bilateral brain abscess, Escherichia coli, Staphylococcus aureus, neurosurgery, stereotactic aspiration.
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