{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:36:50Z","timestamp":1769726210009,"version":"3.49.0"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"21","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,11,24]]},"abstract":"\n BACKGROUND<\/jats:title>\n Secondary infection of cerebral cavernous malformations (CCMs) is exceedingly rare, with only a few cases reported in the literature. While CCMs are typically sporadic or familial vascular malformations, there is growing evidence that local or systemic infections may influence their pathogenesis or complicate existing lesions.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n \n The authors report the case of a 5-year-old boy who presented with clinical features of meningitis and was found to have a right frontal multilobulated cystic mass with appearances concerning for abscess or neoplasm. The patient underwent resection, which confirmed a cavernous malformation with superimposed abscess formation. Cultures identified\n Streptococcus pneumoniae<\/jats:italic>\n , and subsequent investigations revealed multiple CCMs as well as a pathogenic\n KRIT1<\/jats:italic>\n gene mutation. The child made a complete recovery with targeted antibiotic therapy.\n <\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n \n This is the first documented case of a CCM secondarily infected by\n S. pneumoniae<\/jats:italic>\n . It emphasizes the importance of considering infection in patients with known or suspected CCMs presenting with systemic or intracranial infection, particularly when imaging is atypical. Furthermore, this case provides insight into CCM biology: in\n KRIT1<\/jats:italic>\n mutations, impaired endothelial integrity may predispose lesions to inflammatory and infectious insults, supporting the concept that cavernomas are dynamic vascular malformations shaped by genetic, immune, and infectious interactions.\n <\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25628<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25628","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:13:19Z","timestamp":1769685199000},"source":"Crossref","is-referenced-by-count":0,"title":["Cerebral cavernous malformation with secondary bacterial infection: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Kantha Siddhanth","family":"Gujjari","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameen","family":"Farsakh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick P.","family":"Mariajoseph","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia"},{"name":"Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bi Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia"},{"name":"Department of Neurosurgery, Canberra Hospital, Garran, Australian Capital Territory, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amitha","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia"},{"name":"Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beena","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia"},{"name":"Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Badran","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"Neurosurgery","first-page":"665","article-title":"Synopsis of guidelines for the clinical management of cerebral cavernous malformations: consensus recommendations based on systematic literature review by the angioma alliance scientific advisory board clinical experts panel","volume":"80","author":"Akers","year":"2017","unstructured":"Akers AAl-Shahi Salman RA Awad ISynopsis of guidelines for the clinical management of cerebral cavernous malformations: consensus recommendations based on systematic literature review by the angioma alliance scientific advisory board clinical experts panel. Neurosurgery. 2017;80(5):665-680."},{"key":"bib2","series-title":"Handb Clin Neurol","first-page":"241","article-title":"Epidemiology of cavernous malformations","volume":"143","author":"Goldstein","year":"2017","unstructured":"Goldstein HESolomon RA.Epidemiology of cavernous malformations. Handb Clin Neurol. 2017;143:241-247."},{"issue":"6","key":"bib3","series-title":"N Engl J Med","first-page":"343","article-title":"Cerebral cavernous malformations. Incidence and familial occurrence","volume":"319","author":"Rigamonti","year":"1988","unstructured":"Rigamonti DHadley MNDrayer BPCerebral cavernous malformations. Incidence and familial occurrence. N Engl J Med. 1988;319(6):343-347."},{"issue":"12","key":"bib4","series-title":"Childs Nerv Syst","first-page":"3627","article-title":"Campylobacter fetus seeding of a cavernous malformation resulting in brain abscess: case report and literature review","volume":"39","author":"Amoah","year":"2023","unstructured":"Amoah KKABeach IRTeague JMOlszewski AMDeWitt JCDucis KA.Campylobacter fetus seeding of a cavernous malformation resulting in brain abscess: case report and literature review. Childs Nerv Syst. 2023;39(12):3627-3631."},{"issue":"2","key":"bib5","series-title":"Australas Radiol","first-page":"144","article-title":"Pyogenic abscess complicating a resolving cerebral haematoma secondary to a cavernous haemangioma: computed tomography and magnetic resonance imaging findings","volume":"49","author":"Borsaru","year":"2005","unstructured":"Borsaru ADNaidoo P.Pyogenic abscess complicating a resolving cerebral haematoma secondary to a cavernous haemangioma: computed tomography and magnetic resonance imaging findings. Australas Radiol. 2005;49(2):144-150."},{"issue":"3","key":"bib6","series-title":"Neurosurgery","first-page":"749","article-title":"Seeding of a cavernous angioma with Mycoplasma hominis: case report","volume":"53","author":"House","year":"2003","unstructured":"House PDunn JCarroll KMacDonald J.Seeding of a cavernous angioma with Mycoplasma hominis: case report. Neurosurgery. 2003;53(3):749-752."},{"issue":"11","key":"bib7","series-title":"Int J Clin Exp Med","first-page":"20524","article-title":"Intracranial aspergillus fumigatus infection complicated with cavernous hemangioma: case report and literature review","volume":"8","author":"Sun","year":"2015","unstructured":"Sun YYu JLi GHuang H.Intracranial aspergillus fumigatus infection complicated with cavernous hemangioma: case report and literature review. Int J Clin Exp Med. 2015;8(11):20524-20531."},{"key":"bib8","series-title":"StatPearls","article-title":"Streptococcal meningitis","author":"Mandziuk","year":"2025","unstructured":"Mandziuk JKuchar EP.Streptococcal meningitis. In: StatPearls. StatPearls Publishing; 2025. 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Neurosurgery. 2003;53(3):749-752."},{"issue":"11","key":"bib7","series-title":"Int J Clin Exp Med","first-page":"20524","article-title":"Intracranial aspergillus fumigatus infection complicated with cavernous hemangioma: case report and literature review","volume":"8","author":"Sun","year":"2015","unstructured":"Sun YYu JLi GHuang H.Intracranial aspergillus fumigatus infection complicated with cavernous hemangioma: case report and literature review. Int J Clin Exp Med. 2015;8(11):20524-20531."},{"key":"bib8","series-title":"StatPearls","article-title":"Streptococcal meningitis","author":"Mandziuk","year":"2025","unstructured":"Mandziuk JKuchar EP.Streptococcal meningitis. In: StatPearls. StatPearls Publishing; 2025. Accessed November 6, 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554448\/"},{"issue":"1","key":"bib9","series-title":"Asian J Neurosurg","first-page":"97","article-title":"Intracranial cavernous malformation with concomitant isolated cerebral mucormycosis infection: a case report","volume":"19","author":"Sengar","year":"2024","unstructured":"Sengar PPandey NKailashiya VSingh VK.Intracranial cavernous malformation with concomitant isolated cerebral mucormycosis infection: a case report. Asian J Neurosurg. 2024;19(1):97-100."},{"issue":"1","key":"bib10","series-title":"Childs Nerv Syst","article-title":"Cerebral cavernous malformation with associated Streptococcus pyogenes abscess in a child: a case report and literature review","volume":"41","author":"Sanders","year":"2024","unstructured":"Sanders MIBagga Vde Lacy PUshewokunze S.Cerebral cavernous malformation with associated Streptococcus pyogenes abscess in a child: a case report and literature review. 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