Work

Legionella in the brain: First culture-confirmed post-surgical abscess case and its successful management

Year: 2025

Type: article

Abstract: • First confirmed L. pneumophila brain abscess post-neurosurgery using culture and molecular methods. • Only six Legionella brain abscess cases have been reported historically (including other species). • Positive antigenuria in abscess fluid, although not validated diagnostically, guided effective therapy. • This case highlights the risk of post-surgical infection via electrode pathways and the importance of home water contamination surveillance. Post-neurosurgical brain abscesses are documented in approximately 9% of cases, with causative pathogens often linked to polymicrobial or nosocomial origins. Case report. We report the first case of post-neurosurgical Legionella pneumophila brain abscess in a 55-year-old woman with drug-resistant epilepsy. The abscess developed following stereo-electroencephalography and thermocoagulation procedures, manifesting as hemiparesis and vomiting. Diagnosis was confirmed via 16S rRNA PCR, antigen testing, and Buffered Charcoal Yeast Extract (BCYE) culture. Treatment with targeted antibiotics, including levofloxacin and rifampicin, led to a complete recovery without sequelae. Investigation identified the patient’s home water system as the infection source. This case highlights the importance of molecular diagnostics and tailored therapy in managing rare brain abscesses.

Source: Infectious Diseases Now

DOI: 10.1016/j.idnow.2025.105182

Authors: Philippe Lavrard-Meyer, Piseth Seng, Fabrice Bartolomei, Andreas Stein, Romain Carron