Iatrogenic cerebral abscess leading to resolution of severe delusional disorder

BMJ Case Rep. 2019 Dec 2;12(12):e232394. doi: 10.1136/bcr-2019-232394.

Abstract

A cerebral abscess (focal infection of brain parenchyma) carries a high mortality and morbidity. Iatrogenic cerebral abscesses are less common and make up 10% of all cases. The presence of a cerebral abscess can rarely improve a patient's prognosis and quality of life, however this case illustrates an abscess and its treatment following a prolonged course of antibiotics leading to resolution of a severe psychotic disorder. This is a case report of a 32-year-old female inpatient at a psychiatric hospital with a long-standing history of congenital hydrocephalus, cerebral palsy and organic delusional disorder who developed an iatrogenic cerebral abscess after insertion of an implantable intracranial pressure monitoring device. After receiving treatment of 6 weeks of intravenous meropenem the patient's mental condition rapidly improved, she became stable and euthymic and was discharged home. The patient has since had no delusions or hallucinations and is living independently at home.

Keywords: delusional disorder; neurosurgery; psychiatry.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Brain Abscess / complications
  • Brain Abscess / diagnostic imaging
  • Brain Abscess / drug therapy*
  • Brain Abscess / microbiology
  • Female
  • Humans
  • Iatrogenic Disease*
  • Magnetic Resonance Imaging
  • Meropenem / administration & dosage*
  • Neurophysiological Monitoring / adverse effects
  • Neurophysiological Monitoring / instrumentation
  • Remission Induction
  • Schizophrenia, Paranoid / complications
  • Schizophrenia, Paranoid / drug therapy*

Substances

  • Anti-Bacterial Agents
  • Meropenem