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Reports on brain abscess in addicts are surprisingly limited in the literature.
Presented is a 37-year-old male, who had been an amphetamine addict for four years and was hospitalized under suspicion of a brain tumor.
Neurological examination revealed somnolence, left homonymous hemianopsia, bilateral choked disks, mydriasis with sluggish response to light on the right, and left hemiparesis. CT scan showed a low density area with a markedly enhanced ring-blush in the right occipital lobe. Angiography showed an avascular area with a halo formation in the venous phase. A brain abscess was diagnosed and an emergent operation was performed. Fifty ml of yellowish pus was aspirated through a right occipital craniotomy and the abscess was totally extirpated. Staphylococcus aureus grew from the pus.
The possibility of brain abscess should be kept in mind when an addict shows focal neurological signs, or the signs of increased intracranial pressure. CT with contrast enhancement is the most useful diagnostic tool in such cases.
