Lung abscess with metastatic brain abscess- A case report

Abstract

Brain abscess can result from spread of infection from contiguous sites or from distant hematogenous spread. Hematogenous spread from a distant site as from the lungs is more common with cyanotic congenital heart disease and in patients with infective endocarditis. We report a case of hematogenous spread of brain abscess from lung in a patient who had no concurrent heart disease. Klebsiella pneumonia was isolated both from brain abscess and from lung abscess. A fifty years old lady with uncontrolled sugars presented with cough with expectoration and fever. Chest X ray showed cavity with fluid level on the right side and sputum culture showed Klebsiella pneumoniae. She was treated with sensitive antibiotics. During in hospital stay she developed headache and blurring of vision. CT brain showed a right parietal lobe abscess. She underwent decompression procedure and abscess from brain was drained which also revealed growth of Klebsiella pneumoniae. Her echo was normal. She was treated with sensitive antibiotics and had clinical improvement. While treating a case of lung abscess, clinicians should be aware of the possibility of metastatic spread and a high index of suspicion and a radiological imaging leads to early diagnosis and treatment.