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        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introdu&#231;&#227;o&#58;</span> O abcesso cerebral &#40;AC&#41; pode surgir como complica&#231;&#227;o de uma grande variedade de infec-&#231;&#245;es&#44; traumatismos ou cirurgias&#46; Os microrganismos podem atingir o c&#233;rebro por contiguidade ou por dis-semina&#231;&#227;o hematog&#233;nea&#46; Os AC est&#227;o descritos como uma complica&#231;&#227;o rara de bronquiectasias &#40;BQ&#41;&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Caso cl&#237;nico&#58;</span> Mulher de 44 anos com hist&#243;ria de tuberculose pulmonar na inf&#226;ncia e com diagn&#243;stico de BQ bilaterais extensas que apresentou altera&#231;&#245;es do comportamento e posteriormente paresia do 6&#46;&#186; ner-vo craniano esquerdo&#44; tendo sido diagnosticados AC m&#250;ltiplos&#46; O estudo microbiol&#243;gico exaustivo foi negativo&#46; A pesquisa de focos de infec&#231;&#227;o prim&#225;ria revelou apenas a presen&#231;a de BQ infectadas&#46; Efectuou tratamento antibi&#243;tico emp&#237;rico e antiedematoso&#44; com melhoria cl&#237;nica progressiva&#46; Contudo&#44; por persist&#234;ncia das les&#245;es cerebrais&#44; foi submetida a excis&#227;o cir&#250;rgica dos AC&#46; Teve alta com diplopia&#44; sem outras altera&#231;&#245;es neurol&#243;gicas&#46;</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclus&#227;o&#58;</span> No presente caso cl&#237;nico&#44; as BQ foram o &#250;nico foco de infec&#231;&#227;o detectado&#44; motivo pelo qual&#44; nos doentes com esta patologia e com altera&#231;&#245;es neurol&#243;gicas <span class="elsevierStyleItalic">de novo</span>&#44; dever&#225; ser pesquisada a exist&#234;ncia de les&#245;es infecciosas do sistema nervoso central&#46;</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;2&#41;&#58; 319-324</span></p></span>"
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        "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Background&#58;</span> Brain abscess can arise as a complication of a variety of infections&#44; trauma or surgery&#46; Bac-teria can invade the brain by direct spread or through haematogenous seeding&#46; Brain abscesses are described as a rare complication of bronchiectasis&#46;</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Case description&#58;</span> A 44-year-old woman with pul-monary tuberculosis in childhood and with the diagnosis of bilateral extensive bronchiectasis who presented behaviour alterations and later&#44; paresis of the sixth cranial nerve&#44; was diagnosed multiple brain abscesses&#46; The microbiological exams were negative&#46; The study of the primary focus of infection could only identify infected bronchiectasis&#46; Empiric antibiotics and anti-oedematous treatment were prescribed with progressive clinical improvement&#46; Because of inadequate response she was submitted to surgery&#46; She was discharged with diplopia&#44; without any other neurological alterations&#46;</p><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusion&#58;</span> In the present clinical case&#44; the infected bronchiectasis were the only focal infection detected&#44; so in patients with this disease and with new neurological manifestations&#44; infected lesions in the central nervous system should be excluded&#46;</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;2&#41;&#58; 319-324</span></p></span>"
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Vol. 15. Issue 2.
Pages 319-324 (March - April 2009)
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Vol. 15. Issue 2.
Pages 319-324 (March - April 2009)
Caso Clínico/Case Report
Open Access
Abcessos cerebrais múltiplos – Uma complicação rara de bronquiectasias
Multiple brain abscesses – A rare complication of bronchiectasis
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6644
Natália Melo1,
Corresponding author
nataliafmelo@hotmail.com

Natália Melo, Serviço de Pneumologia, Hospital de S. João, Alameda Professor Hernâni Monteiro, 4202-451 Porto, Telefone: 919371855.
, Vicens Diaz-Brito2, Clara Chamadoira3, Isabel Gomes4, Adelina Amorim5
1 Interna Complementar de Pneumologia – Serviço de Pneumologia – Director de Serviço: Prof. Dr. Venceslau Hespanhol
2 Assistente Hospitalar de Doenças Infecciosas – Serviço de Doenças Infecciosas – Director de Serviço: Prof. Dr. António Sarmento
3 Interna Complementar de Neurocirurgia – Serviço de Neurocirurgia – Director de Serviço: Prof. Dr. Rui Vaz
4 Assistente Hospitalar Graduada de Pneumologia – Serviço de Pneumologia
5 Assistente Hospitalar de Pneumologia – Serviço de Pneumologia Hospital de S. João, Porto
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Resumo

Introdução: O abcesso cerebral (AC) pode surgir como complicação de uma grande variedade de infec-ções, traumatismos ou cirurgias. Os microrganismos podem atingir o cérebro por contiguidade ou por dis-seminação hematogénea. Os AC estão descritos como uma complicação rara de bronquiectasias (BQ).

Caso clínico: Mulher de 44 anos com história de tuberculose pulmonar na infância e com diagnóstico de BQ bilaterais extensas que apresentou alterações do comportamento e posteriormente paresia do 6.º ner-vo craniano esquerdo, tendo sido diagnosticados AC múltiplos. O estudo microbiológico exaustivo foi negativo. A pesquisa de focos de infecção primária revelou apenas a presença de BQ infectadas. Efectuou tratamento antibiótico empírico e antiedematoso, com melhoria clínica progressiva. Contudo, por persistência das lesões cerebrais, foi submetida a excisão cirúrgica dos AC. Teve alta com diplopia, sem outras alterações neurológicas.

Conclusão: No presente caso clínico, as BQ foram o único foco de infecção detectado, motivo pelo qual, nos doentes com esta patologia e com alterações neurológicas de novo, deverá ser pesquisada a existência de lesões infecciosas do sistema nervoso central.

Rev Port Pneumol 2009; XV (2): 319-324

Palavras-chave:
Bronquiectasias
abcesso cerebral
Abstract

Background: Brain abscess can arise as a complication of a variety of infections, trauma or surgery. Bac-teria can invade the brain by direct spread or through haematogenous seeding. Brain abscesses are described as a rare complication of bronchiectasis.

Case description: A 44-year-old woman with pul-monary tuberculosis in childhood and with the diagnosis of bilateral extensive bronchiectasis who presented behaviour alterations and later, paresis of the sixth cranial nerve, was diagnosed multiple brain abscesses. The microbiological exams were negative. The study of the primary focus of infection could only identify infected bronchiectasis. Empiric antibiotics and anti-oedematous treatment were prescribed with progressive clinical improvement. Because of inadequate response she was submitted to surgery. She was discharged with diplopia, without any other neurological alterations.

Conclusion: In the present clinical case, the infected bronchiectasis were the only focal infection detected, so in patients with this disease and with new neurological manifestations, infected lesions in the central nervous system should be excluded.

Rev Port Pneumol 2009; XV (2): 319-324

Key-words:
Bronchiectasis
brain abscess
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