Mumbai docs find woman suffering from repeated headache had rare brain infection 

​

A severe headache quickly spiralled into a life-threatening neurological emergency for a 31-year-old woman from Gujarat but Mumbai doctors have come to her rescue, and helped her walk again after timely surgery. 

After developing weakness on the right side of her body and slurred speech, she was admitted to a hospital where a brain scan showed swelling. She was started on conservative treatment, but her condition took an alarming turn when she began experiencing recurrent seizures. As her neurological symptoms worsened despite treatment, she was referred to Wockhardt Hospitals in Mumbai Central, where Dr Prashant Makhija, consultant neurologist, took over her care.

By the time she arrived at the city-based hospital, the priority was to understand why a young woman with no obvious explanation for her condition was deteriorating despite treatment. Fresh brain imaging revealed signs of an evolving brain abscess, which is an infection within the brain that appeared to be progressing towards pus formation. The medical team immediately controlled her seizures and started broad-spectrum antibiotics while closely monitoring her neurological status.

For a short period, she appeared to stabilise but the improvement did not last. Her right-sided weakness progressed further, raising concerns that the infection was not responding to medication alone. The team realised that waiting any longer could lead to irreversible brain damage.

After detailed discussions with the family, the decision was made to proceed with emergency neurosurgery. Dr Mazda K Turel aspirated the infected collection from the brain, allowing the sample to be sent for specialised microbiological analysis. The laboratory findings revealed an unexpected diagnosis called cerebral melioidosis, a rare infection caused by the bacterium Burkholderia pseudomallei. While melioidosis most commonly affects the lungs, skin and other organs, involvement of the brain is uncommon, making it a difficult diagnosis to suspect during the initial stages of illness.

The infection had also triggered significant swelling inside the brain. To relieve the dangerously raised pressure, the surgical team performed a decompressive craniectomy, a procedure in which a portion of the skull is temporarily removed to allow the swollen brain to expand safely. Once the infection had completely resolved after a prolonged course of targeted antibiotics, the skull bone was successfully replaced in a planned second surgery.

Explaining the challenges of the case, Dr Makhija said, “Brain infections can often resemble stroke or other neurological disorders in the early stages, especially when patients present with weakness, slurred speech and seizures. When her neurological deficits worsened despite empirical treatment, it became clear that we needed to rethink the diagnosis. Repeat imaging, continuous neurological assessment and close collaboration with our neurosurgical colleagues were critical in identifying the underlying infection before permanent brain injury could occur.”

Highlighting the importance of timely surgical intervention, Dr Turel explained, “Surgery was necessary not only to reduce pressure on the brain but also to establish the diagnosis. Draining the infected collection allowed us to identify the exact organism and tailor the antibiotic treatment accordingly. In cases like these, surgery and medication complement each other, and neither alone would have achieved the same outcome.”

Following surgery, the patient’s seizures came under control and her neurological recovery gradually progressed with intensive medical treatment and rehabilitation. She later returned to Gujarat to complete her prolonged antibiotic therapy while remaining in regular contact with her treating team. Today, her antibiotics have been completed, her skull has been successfully reconstructed, and she has regained the ability to walk independently with the support of a walking stick.

This highlights how rare infections can masquerade as more common neurological conditions, delaying diagnosis and treatment. It also underscores the importance of recognising persistent warning signs, repeating investigations when a person’s condition changes, and adopting a multidisciplinary approach that combines neurology, neurosurgery and microbiology to achieve the best possible outcome.