meropenem and Brain-Edema

We describe a case of a 25-year-old female with an acute left otomastoiditis, accompanied by a left temporal extradural abscess with moderate perifocal edema and meningitis. Intravenous meropenem (2 g 8-hourly) and intravenous methylprednisolone (40 mg once daily) were commenced empirically. Teicoplanin (400 mg once daily intravenously) was added after 5 days when culture results were available. Teicoplanin was discontinued on day 25 but meropenem and methylprednisolone were continued for a further 15 days, after which the abscess completely resolved without sequelae. No treatment-induced adverse effects or seizures were observed. Thus, in selected patients, antibacterials (in conjunction with a corticosteroid) may be successfully used without surgery to treat brain abscesses and in such circumstances meropenem is a useful option for empiric therapy.

Topics: Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents; Brain Abscess; Brain Edema; Drug Therapy, Combination; Female; Humans; Injections, Intravenous; Mastoiditis; Meningitis; Meropenem; Methylprednisolone; Teicoplanin; Thienamycins; Tomography, X-Ray Computed