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Brain Abscess

Torin W. Karsonovich, DO and Brandon G. Gaynor, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Purulent collection within the brain most commonly arising from hematogenous sources of infection (pulmonary, cardiac, renal). Contiguous spread (sinusitis, dental, and mastoiditis) ...

DIAGNOSIS

HISTORY

  • Recent onset of progressive headache

  • New focal neurologic deficit or hemiparesis

  • Altered mental status progressing to stupor and coma

  • Nausea, vomiting, lethargy

  • Seizures

PHYSICAL EXAM

  • Afebr...

TREATMENT

Emergency neurosurgical consultation is indicated for brain abscess. 

GENERAL MEASURES

  • Treatment of brain abscess requires a combination of surgical intervention and appropriate antimicrobial ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Prolonged ICU stay may be required in critically ill patients.

  • May need long-term rehabilitative care

Patient Monitoring

  • Postsurgical monitoring, as needed

  • Serial CT ...

REFERENCES

1
Brouwer MC, Tunkel AR, McKhann GMJr, et al. Brain abscess. N Engl J Med.  2014;371:447–456. {L-End} [View Abstract on OvidMedline]
2
Britt RB, Enzmann DR. Clinical stages of human brai...

CODES

ICD10

  • G06.0 Intracranial abscess and granuloma

  • A06.6 Amebic brain abscess

  • B37.89 Other sites of candidiasis

ICD9

  • 324.0 Intracranial abscess

  • 006.5 Amebic brain abscess

  • 112.89 Other candidiasis of other ...

CLINICAL PEARLS

  • Headache, altered mental status, and seizure are common presenting symptoms of a brain abscess.

  • Determining the portal of entry and source of infection is helpful but not always possibl...

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