Abscess of the pontine dorsolateral tegmentum due to E. coli and influenza A(H1N1)pdm09 virus co-infection

Brain stem abscesses are rare entities that predominantly affect the pons. A wide variety of microorganisms may be implied, depending on focus dissemination. We present case a female patient with multiple comorbidities who developed multi-lobar pneumonia due to influenza A(H1N1)pdm09 virus during postoperative period after an emergent cholecystectomy, requiring mechanical ventilation (MV). Following clinical improvement and withdrawal MV, did not recover consciousness. Forty-eight hours later, imaging exams showed abscess in left pontine dorsolateral tegmentum –a region recently associated coma-. Despite administration broad-spectrum antibiotics, died five days later. This illustrates importance considering as cause poor neurological course critically ill patients, well need for doing rule out intracranial lesions, particularly coma-associated areas.