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Ciliated respiratory epithelium encapsulating Pseudomonas brain abscess due to prior trauma
  1. Nihar Kanta Jena,
  2. Justin Khine,
  3. Nadia Khosrodad and
  4. Geetha Krishnamoorthy
  1. Internal Medicine, Saint Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
  1. Correspondence to Dr Nihar Kanta Jena; nihar.jena{at}


Bacterial brain abscesses are typically spread through a haematogenous route. Open head wounds and neurosurgical interventions are uncommon aetiologies. Ectopic tissue found in the cerebral cortex is usually ascribed almost entirely from carcinomas. Here, we describe a 57-year-old gentleman who, 22 years after a fireworks related traumatic injury to the left orbit, presented with headaches and altered behaviour. Imaging revealed an abscess immediately superior to the orbit, whose bacterial aetiology was identified to be Pseudomonas aeruginosa, encapsulated by ciliated respiratory epithelium. This represents a case in which tissue was displaced during the initial trauma or craniofacial reconstructive surgery from the frontal sinus.

  • infectious diseases
  • trauma CNS /PNS
  • neurosurgery

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  • Contributors NKJ is an internal medicine resident who acted as the lead author for this case report for identifying the case, writing of the manuscript and participated in patient care. JK and NK are internal medicine residents who contributed to patient management, review literature and helped in writing the manuscript. GK is the program director of internal medicine and finalised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin’s consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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