European Journal of Cardiovascular Medicine

Background: -Brain abscess is defined as a focal infection within the brain parenchyma which starts as a localised area of cerebritis which is subsequently converted into a collection of pus within a well vascularised capsule.Intracranial abscesses are life-threatening infection that pose a diagnostic challenge not only to the neurosurgeon but also to the microbiologists. Detailed studies documenting the spectrum of infecting agents involved in brain abscesses are limited from India. Case report: -A 17-year-oldboy presented to Trauma and emergency Department AIIMS Raipur in a drowsy state with complaints of severe headache and right sided ear discharge for 15 days,fever on and off and weakness over all limbs for 1 day.Patient had a history of chronic suppurative otitis media (CSOM) of right ear discharge without any evidence of recent trauma or neurological procedure.Contrast enhanced CT brain showed cerebellar abscess with compressed fourth ventricle. Patient underwent emergency craniotomy, drainage of abscess and extra ventricular drain. Pus sample on gram stain showed gram positive cocci in chains and pairs and few gram-negative bacilli.Aerobic bacterial culture revealed pinpoint beta-haemolyticcolonies along with few translucentnonhaemolytic colonies which failed to grow in MacConkey agar.The two isolates were identified asStreptococcus constellates and.Spingobacterium multivorumby VITEK II system.Antibiotic susceptibility pattern was performed by Kirby Bauer Disk diffusion and VITEK II system compact automated ID/ AST system.Initial empirical antibiotics were replaced withIV vancomycin as both the organisms were found sensitive to it. Patient responded with improved Glasgow comma Score and gradual resolution of abscess size which was evident on successive postoperative CECT Scan findings. Conclusion: Streptococcus constellatus and Spingobacterium multivorumboth are ubiquitous.Haematogenous spread from ear could have resulted in brain abscess.Appropriate sampling and use of automated instruments may increase isolation of new and unusualpathogensand result in early and appropriate management of brain abscess