American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Medical Case Reports. 2016, 4(1), 1-4
DOI: 10.12691/ajmcr-4-1-1
Open AccessCase Report

A Unique Case of Bilateral Frontal Lobe Abscesses in a Young Male

Mary Mathews1, , Yousef Botros1, Ariel Fromowitz2, Alex Riss1, Ali Zahran1 and Michael Lange1

1Department of Internal Medicine, New York Medical College-St. Joseph’s Regional Medical Center, Paterson, New Jersey

2Department of Internal Medicine, New York Medical College, Valhalla, New York

Pub. Date: January 05, 2016

Cite this paper:
Mary Mathews, Yousef Botros, Ariel Fromowitz, Alex Riss, Ali Zahran and Michael Lange. A Unique Case of Bilateral Frontal Lobe Abscesses in a Young Male. American Journal of Medical Case Reports. 2016; 4(1):1-4. doi: 10.12691/ajmcr-4-1-1


A brain abscess is a serious complication that may arise from a source of infection from within the cranium or from an extracranial source. We discuss a unique case of a 36 year-old male with a history of heroin abuse who presented with pan-sinusitis and bilateral frontal lobe abscesses. The patient presented with the symptoms of prolonged drowsiness and a left eyelid infection for which he was already receiving treatment. He had a normal neurological exam upon admission. CT scan of the head was performed which showed left orbital cellulitis, pan-sinusitis, and bilateral frontal lobe abscesses. A follow-up MRI was performed as well which showed cerebral edema. The patient was started on broad spectrum antibiotics, and neurosurgical aspiration and drainage of the abscesses was performed. Microbiological culture results enabled us to narrow the spectrum of the antibiotics. The patient completed his course of antibiotics. At a follow up exam 6 weeks later, the patient had no neurological deficits, and the abscesses seemed to be improving as seen in the imaging.

brain abscess pan-sinusitis frontallobe bilateral stereotactic intraparenchymal heroin abuse

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


Figure of 3


[1]  Brouwer, M. C., Coutinho, J. M., and van de Beek, D. (2014).Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology, 82(9), 806-813.
[2]  Muzumdar, D., Jhawar, S., and Goel, A. (2011). Brain abscess: an overview. International Journal of Surgery, 9(2), 136-144.
[3]  Sharma, B. S., Gupta, S. K., and Khosla, V. K. (2000). Current concepts in the management of pyogenic brain abscess. Neurology India, 48(2), 105-111.
[4]  Brouwer, M. C., Tunkel, A. R., McKhann, G. M. 2nd, and van de Beek, D. (2014). Brain abscess. New England Journal of Medicine, 371(5), 447-456.
[5]  Rana, M. A., Mady, A. F., Alharthy, A., Ramadan, O. E., Hashim, W. T., Ashmawi, S. A., Alodat, M. A., AlKurdi, M. H., Gharba, M. M., Ragab, A., Hallak, M. A. (2014). Brain abscess in a drug abuser with history of cocaine sniffing. European Radiology.
[6]  Rao, N. (1988). Brain abscess: A complication of cocaine inhalation. New York State Journal of Medicine.
[7]  Villa, P. D. (1999). Midfacial Complications of Prolonged Cocaine Snorting. Journal of the Canadian Dental Association, 65, 218-223.
[8]  Miranda, H. A., Castellar-Leones, S. M., Elzain, M. A., and Moscote-Salazar, L. R. (2013). Brain abscess: Current management. Journal of Neurosciences in Rural Practice, S67-S81.
[9]  Friedlander, R. M., Gonzalez, R. G., Afridi, N. A., and Pfannl, R. (2003). Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 16-2003. A 58-year-old woman with left-sided weakness and a right frontal brain mass. New England Journal of Medicine, 348(21), 2125-2132.
[10]  Lee, K. S., and Lee, B.L. (2013) Cerebritis arising from acute sinusitis evolving into a large brain abscess. Pediatric Neurology, 48(6), 475-476.
[11]  Zaffiri, L., Abdulmassih, R., Boyaji, S. Bagh, I., Campbell, A. R., and Loehrke, M. E. (2013). Brain abscess induced by Propionibacterium acnes in a patient with severe chronic sinusitis. The New Microbiologica, 36(3), 325-329.
[12]  Paul S. P., and Jerwood, S. (2012). Group A streptococcal septicemia, meningitis and cerebral abscess: case report and literature review. The Turkish Journal of Pediatrics, 54(2), 180-183.