Brain stem abscesses: cure with medical therapy, case report, and review.

A patient with a brain stem abscess that was cured with medical therapy alone is described. The English-language literature on brain stem abscesses is reviewed. Computed tomography (CT) and magnetic resonance imaging (MRI) have revolutionized the rapidity with which the diagnosis can be made and have markedly changed the prognosis for patients with brain stem abscesses. To my knowledge, all patients whose brain stem abscesses have been diagnosed by MRI or CT have survived although some have had neurological residuals. Patients are usually treated with surgical excision or aspiration along with antibiotics. Our patient was treated with medical therapy alone, and this case represents the fourth reported cure with this treatment modality. Medical therapy may be anticipated to cure patients with brain stem abscesses whose conditions are diagnosed expeditiously with CT or MRI techniques.