Objective: One of the infections seen in neutropenic patients is brain abscess. Bacterias (Enterobacteriaceae, Nocardia), fungi and protozoa (toksoplazma) are the common etiologic agents. Mortality is extremely high in spite of antimicrobial therapy. So we intended to present an acute lenfoblastic leukemia patient with brain abscess.

Case: Twenty-seven years old female with acute lymphoblastic leukemia suddenly developed fever, headache, nausea, vomiting and sensorymotor loss on the right side of her face on the 27th day of chemotherapy. Combination of cefepime + amikacin + fluconazole + metronidazole was started after the detection of multiple lesions of brain abscess by magnetic resonans imaging (MRI). Vancomycin was added to the combination on the 3rd day since fever was still high and clinical signs and symptoms persisted. On the 3rd day of new combination flucanazole was discarded and liposomal amphotericin B was added instead. On the 2nd day of liposomal amphotericin B fever and neurological signs and symptoms disappeared. Control MRI revealed no abscess lesions.

Conclusion: We presented this case since brain abscess has a high mortality rate in neutropenic patients and it was treated successfully by ampirical antimicrobial approach.