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

INTRODUCTION

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.

CONCLUSION

This case highlights the importance of molecular diagnostics and tailored therapy in managing rare brain abscesses.