Multiple primary brain abscesses in a 14 years old immunocompetent boy: A tale of Proteus mirabilis infestation from Pakistan

Brain abscess (BA) formation that may be due to due to Gram-positive bacteria commonly and less commonly due Gram-negative bacteria affects pediatric population. Most cases are secondary to the involvement of ear, nose, throat and sinuses (ENTS). We describe a rare case of a 14 year old patient presenting with generalized tonic clonic seizures for the last six months associated with fever, vomiting and headache. ENTS examination was normal. Neuroimaging was suggestive of multiple left fronto-pariettal space occupying lesions. Modified pterional craniotomy was done to excise the multiloculated, encapsulated lesion with yellow-green pus. Culture sensitivity yielded <i>Proteus mirabilis</i>. Patient was discharged from the hospital uneventfully. The diagnosis of multiple primary brain abscesses secondary to <i>Proteus mirabilis</i> is very rare and it should be considered in the list of differentials of multiple brain abscesses when the systematic examination is normal. Early surgical excision is the key to a successful outcome.