{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T19:01:40Z","timestamp":1783191700273,"version":"3.54.6"},"reference-count":8,"publisher":"SMC Media","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction:\u00a0Brain abscesses remain a significant clinical challenge, particularly in cases involving multidrug-resistant (MDR) organisms or failure of standard surgical and medical therapy. Newer adjunctive techniques, such as continuous irrigation therapy, have been explored to enhance infection control and patient outcomes in these complex scenarios. Case description:\u00a0We present two cases of brain abscess treated at a tertiary care centre using continuous abscess cavity irrigation after conventional interventions proved insufficient. The first patient, a 15-year-old male, experienced recurrent MDR brain abscesses despite multiple surgical procedures and broad-spectrum antibiotics. Initiation of continuous irrigation, combined with targeted antimicrobial therapy, resulted in rapid clinical stabilisation and marked radiological improvement, with minimal long-term sequelae. The second patient, a 65-year-old female, developed multiple brain abscesses after traumatic brain injury and decompressive surgery. Although continuous irrigation effectively controlled the intracranial infection and imaging confirmed resolution, her neurological recovery was limited due to profound pre-existing brain damage. Conclusion:\u00a0Continuous irrigation therapy appears to be a valuable adjunct in the management of refractory or MDR brain abscesses, facilitating rapid infection control when conventional treatments are inadequate. However, ultimate neurological outcomes are largely dependent on the extent of underlying brain injury. These cases highlight the importance of considering continuous irrigation in selected patients and underscore the need for further research and multidisciplinary collaboration to optimise management protocols and improve patient outcomes.<\/jats:p>","DOI":"10.12890\/2025_005566","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T05:18:30Z","timestamp":1751519910000},"source":"Crossref","is-referenced-by-count":1,"title":["Continuous irrigation for refractory multidrug-resistant brain abscess in two patients"],"prefix":"10.12890","volume":"12","author":[{"given":"Nguyen Quang","family":"Thanh","sequence":"first","affiliation":[{"name":"National Hospital of Tropical Diseases, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Trung","family":"Cap","sequence":"first","affiliation":[{"name":"National Hospital of Tropical Diseases, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vu Dinh","family":"Phu","sequence":"first","affiliation":[{"name":"National Hospital of Tropical Diseases, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mac Duy","family":"Hung","sequence":"first","affiliation":[{"name":"National Hospital of Tropical Diseases, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Quoc","family":"Phuong","sequence":"first","affiliation":[{"name":"Infectious Department, Ha Noi Medical University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Phu","family":"Khiem","sequence":"first","affiliation":[{"name":"National Hospital of Tropical Diseases, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pham Ngoc","family":"Thach","sequence":"first","affiliation":[{"name":"National Hospital of Tropical Diseases, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10397","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"10.12890\/2025_005566_ref1","doi-asserted-by":"crossref","unstructured":"Karageorgopoulos DE, Falagas ME. Current control and treatment of multidrug-resistant Acinetobacter baumannii infections. Lancet Infect Dis 2008;8:751\u2013762. doi: 10.1016\/S1473-3099(08)70279-2","DOI":"10.1016\/S1473-3099(08)70279-2"},{"key":"10.12890\/2025_005566_ref2","doi-asserted-by":"crossref","unstructured":"Brouwer MC, Tunkel AR, McKhann GM 2nd, van de Beek D. Brain abscess. N Engl J Med 2014;371:447\u2013456. doi: 10.1056\/NEJMra1301635","DOI":"10.1056\/NEJMra1301635"},{"key":"10.12890\/2025_005566_ref3","doi-asserted-by":"crossref","unstructured":"Takano T, Ota N, Kondo T, Kusunoki T, Yasuda S, Toh K, et al. A case of brain abscess successfully treated with continuous irrigation therapy. Surg Neurol Int 2025;16:36. doi: 10.25259\/SNI_940_2024","DOI":"10.25259\/SNI_940_2024"},{"key":"10.12890\/2025_005566_ref4","doi-asserted-by":"crossref","unstructured":"Hasdemir MG, Ebeling U. CT-guided stereotactic aspiration and treatment of brain abscesses. An experience with 24 cases. Acta Neurochir (Wien) 1993;125:58\u201363. doi: 10.1007\/BF01401829","DOI":"10.1007\/BF01401829"},{"key":"10.12890\/2025_005566_ref5","doi-asserted-by":"crossref","unstructured":"Maurice-Williams RS. Open evacuation of pus: a satisfactory surgical approach to the problem of brain abscess? J Neurol Neurosurg Psychiatry 1983;46:697\u2013703. doi: 10.1136\/jnnp.46.8.697","DOI":"10.1136\/jnnp.46.8.697"},{"key":"10.12890\/2025_005566_ref6","doi-asserted-by":"crossref","unstructured":"Baig AA, Hess RM, Sprau AC, Kemeny H, Nazari P, Turner R, et al. Breaking the mold: an international, multicenter study on active and continuous irrigation with cerebrospinal fluid exchange for improving outcomes in cerebral ventriculitis. Neurosurgery 2024;70 (Supp. 1):71\u201372. doi: 10.1227\/neu.0000000000002809_257","DOI":"10.1227\/neu.0000000000002809_257"},{"key":"10.12890\/2025_005566_ref7","doi-asserted-by":"crossref","unstructured":"Yang Z, Du L, Liu R, Jian Z, Wan Y. Evaluation of continuous irrigation and drainage with a double-cavity sleeve tube to treat brain abscess. World Neurosurg 2017;106:231\u2013239. doi: 10.1016\/j.wneu.2017.05.117","DOI":"10.1016\/j.wneu.2017.05.117"},{"key":"10.12890\/2025_005566_ref8","doi-asserted-by":"crossref","unstructured":"Baig AA, Hess RM, Sprau AC, Kemeny H, Hashmi E, Nazari P, et al. An international, multicenter feasibility study on active and continuous irrigation with cerebrospinal fluid exchange for improving outcomes in cerebral ventriculitis. Neurosurgery 2025;96:514\u2013520. doi: 10.1227\/neu.0000000000003118","DOI":"10.1227\/neu.0000000000003118"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5566\/4737","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5566\/4734","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5566\/4734","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T10:10:29Z","timestamp":1755511829000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/5566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,3]]},"references-count":8,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.12890\/2025_005566","relation":{"has-manifestation":[{"id-type":"other","id":"1-128-5566-g4737","asserted-by":"subject"},{"id-type":"other","id":"1-128-5566-g4734","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-128","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,3]]}}}