Highlights
- •Immunosuppressed patients are at higher risk of brain abscess and meningitis.
- •Small abscesses on eloquent areas may be treated with medical therapy alone.
- •Close clinical and radiological monitoring is essential to guide treatment.
- •Radiological worsening may be due to Immune Reconstitution Inflammatory Syndrome.
Abstract
The incidence of brain abscess is higher among immunosuppressed patients. We report
a case of a brain abscess in the temporal lobe in a patient under treatment with adalimumab
and methotrexate, who developed radiological worsening. Clinical remission was essential
to suspect Immune Reconstitution Inflammatory Syndrome and to continue empirical antimicrobial
therapy due to the low suspicion of worsening of the abscess itself.
Keywords
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Article info
Publication history
Published online: January 02, 2019
Accepted:
December 23,
2018
Received:
November 25,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
