Gas-containing brain abscess due to gram-positive anaerobic cocci

A successfully treated 19-year-old man with gas-containing brain abscess due to gram-positive anaerobic cocci is described. A CT scan disclosed a right-frontal low-density area with an enhancing rim and a perifocal low-density area. A gas shadow with a gas-fluid level was clearly seen within the cystic cavity. There was a marked improvement in the conscious level and hemiparesis immediately after the operation. On the 7th postoperative day, the patient had almost no neurological deficits. A further CT scan 80 days after the operation showed only a small low-density area at the frontal lobe. No gas-containing brain abscess due to gram-positive anaerobic cocci has been reported except this case. The immediate recognition and institution of therapy using serial CT scans for a gas-containing brain abscess results in a complete cure of the patient. (J.P.N.)