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01 January 2001

Brain abscess as a rare complication in a hemodialysed patient.

M P Barczyk, W J Łebkowski, Z Mariak, J Małyszko, M Myśliwiec

Med Sci Monit 2001; 7(6): CS1329-1333 :: ID: 437409

Abstract

BACKGROUND: Infections remain among the most common morbid events and arean important cause of death in end stage renal disease. They have reduced immune response and increasedhazard of infections due to repeated puncture of an arterio-venous fistula, formation of haematoma atthe site of cannulation and central vein catheterisation. CASE REPORT: We report a case of brain abscessin chronically haemodialysed patient admitted to our department due to haedache, vomiting, acceleratedhypertension and fever. The clinical examination revealed narroving of the right palpebral slit, weepingand right oral angle hanging loose. He had mild microcytic anaemia and high level of g-globulin. Ophtalmologicexamination showed normal oculi fundi. The computed tomography revealed heterogenous mass marginallyenhanced with contrast agent in the right frontal cerebral lobe. The right fronto-temporal craniotomywas performed and the right frontal lobe abscess was found and totally excised. The postoperative coursewas uneventful besides of seizures which were effectively treated with carbamazepine. After bilateralnephrectomy the patient undervent succesfull kidney transplantation and is in good condition withoutany neurological defect. A probable cause of his brain abscess was peridontal abscess recognized 3 monthearlier or bilateral vesicoureteral refluxes. CONCLUSIONS: 1. Uremic patients have a reduced immunocapacityand are a high risk group for infections of various etiology. 2. Prompt eradication of all sources ofinfection is essential in hemodialysed patients.

Keywords: Tomography, X-Ray Computed

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750