FAILURE OF INTRAVENOUS ANTIBIOTIC-THERAPY OF MULTIPLE TEMPORAL BRAIN ABSCESSES CLUE TO PROPIONIBACTERIUM-ACNES REQUIRING TEMPORAL LOBECTOMY

Propionibacterium acnes is a common skin colonizer. Its involvement in brain abscesses is generally described as a complication of neurosurg ical intervention Propionibacterium acnes is susceptible to antibiotic s used as treatment of anaerobic infections, except for the 5-nitroimi dazoles. Surgical excision or drainage of a simple abscess combined wi th a long course of antibiotics is considered the treatment of choice. A case of a patient with multiple brain abscesses located in the righ t temporal lobe that occurred after the manipulation of an abscess of the right upper maxillary is reported The patient did not improve desp ite a prolonged course of high-dose intravenous penicillin plus thiamp henicol, and cure was finally obtained after the excision of the right temporal lobe. Culture of the purulent material and the shell of the abscesses yielded P. acnes which was sensitive to all the antibiotics administered to the patient up to the intervention. The temporal lobec tomy was followed by a 6-month course of ofloxacin. One year after the intervention, the patient remained apyretic without any other abscess on cranial computed tomography scan.