Brain abscess in patients with chronic kidney disease: A case-based approach to management in resource-limited settings.

Abstract

The management of patients with brain abscess poses a significant challenge to clinicians in patients with chronic kidney disease. Obtaining a biopsy sample from the affected area is the mainstay in the diagnosis, but it is often unavailable. In most cases, therapy is guided by clinical findings and imaging alone. We discuss three cases of brain abscess- each with a different scenario and discuss the issues faced in management. The first case was a 32-year-old post-renal transplant male patient with a brain abscess due to dematiaceous fungi and was treated with amphotericin. The second case was a 42-year-old female patient with stage 5 chronic kidney disease on maintenance hemodialysis who presented with a brain abscess due to suspected fungal infection based on imaging findings and was managed with antibiotics and voriconazole. The third case was a 42-year-old post-renal transplant male patient who presented with a brain abscess due to nocardiosis and was managed with cotrimoxazole, meropenem and linezolid. We also summarize the approach to the management of brain abscess in resource-limited settings.

• Authors: Nitin Gupta, Rohit Kumar, Sayantan Banerjee, Gagandeep Singh, Sundeep Malla, Yogiraj Ray, Prashant Ramteke, Netto George, Parul Kodan, Anivita Aggarwal, Prabhat Kumar, Pankaj Jorwal, Manish Soneja, Ashutosh Biswas
• Journal: Drug discoveries & therapeutics (Drug Discov Ther) Vol. 14 Issue 2 Pg. 93-97 (May 06 2020) ISSN: 1881-784X [Electronic] Japan
• PMID: 32321877 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Antifungal Agents
• Trimethoprim, Sulfamethoxazole Drug Combination
• Meropenem
• Linezolid
• Voriconazole

Topics

• Adult
• Anti-Bacterial Agents (therapeutic use)
• Antifungal Agents (therapeutic use)
• Bacterial Infections (drug therapy)
• Brain Abscess (drug therapy, etiology)
• Female
• Humans
• Kidney Transplantation
• Linezolid (therapeutic use)
• Male
• Meropenem (therapeutic use)
• Mycoses (drug therapy)
• Renal Insufficiency, Chronic (complications, drug therapy)
• Trimethoprim, Sulfamethoxazole Drug Combination (therapeutic use)
• Voriconazole (therapeutic use)