{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T16:14:21Z","timestamp":1778775261675,"version":"3.51.4"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>The highly lethal cryptogenic brain abscess can be easily misdiagnosed. However, cryptogenic brain abscess caused by <jats:italic>Providencia rettgeri<\/jats:italic> is rarely reported. We present the case of a cryptogenic <jats:italic>Providencia rettgeri<\/jats:italic> brain abscess and analyze the clinical manifestations, imaging findings, treatment, and outcome to improve the level of awareness, aid in accurate diagnosis, and highlight effective clinical management. A 39-year-old man was admitted to the hospital after experiencing acute speech and consciousness disorder for 1 day. The patient had a medical history of nephrotic syndrome and membranous nephropathy requiring immunosuppressant therapy. Magnetic resonance imaging revealed giant, space-occupying lesions involving the brain stem, basal ganglia, and temporal-parietal lobes without typical ring enhancement, mimicking a tumor. Initial antibiotic treatment was ineffective. Afterward, pathogen detection in cerebrospinal fluid using metagenomic next-generation sequencing revealed <jats:italic>Providencia rettgeri<\/jats:italic>. Intravenous maximum-dose ampicillin was administered for 5 weeks, and the patient's symptoms resolved. Cryptogenic <jats:italic>Providencia rettgeri<\/jats:italic> brain abscess typically occurs in patients with impaired immunity. Our patient exhibited a sudden onset with non-typical neuroimaging findings, requiring differentiation of the lesion from stroke and brain tumor. Metagenomic next-generation sequencing was important in identifying the pathogen. Rapid diagnosis and appropriate use of antibiotics were key to obtaining a favorable outcome.<\/jats:p>","DOI":"10.3389\/fneur.2022.1007435","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T11:34:40Z","timestamp":1663932880000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Case report: Cryptogenic giant brain abscess caused by Providencia rettgeri mimicking stroke and tumor in a patient with impaired immunity"],"prefix":"10.3389","volume":"13","author":[{"given":"Yu","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baorong","family":"Lian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xudong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qizheng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daxue","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Sheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liming","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.3389\/fnins.2018.01054","article-title":"A clinical report of two cases of cryptogenic brain abscess and a relevant literature review","volume":"12","author":"Zhou","year":"2019","journal-title":"Front Neurosci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1212\/WNL.0000000000000172","article-title":"Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis","volume":"82","author":"Brouwer","year":"2014","journal-title":"Neurology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1007\/s00701-016-2741-4","article-title":"Retrospective analysis of 620 cases of brain abscess in Chinese patients in a single center over a 62-year period","volume":"158","author":"Zhang","year":"2016","journal-title":"Acta Neurochir (Wien)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1177\/1941874414540684","article-title":"Bacterial brain abscess","volume":"4","author":"Patel","year":"2014","journal-title":"Neurohospitalist."},{"key":"B5","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1046\/j.1469-0691.2003.00651.x","article-title":"A twelve-year review of central nervous system bacterial abscesses; 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