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Brain Abscess

Chetna Dengri, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • A 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 recommended for brain abscess.

  • If associated with sinusitis, endoscopic sinus surgery may be indicated.

GENERAL MEASURES

  • Treatment of brain abscess requi...

ONGOING CARE

Long-term antibiotics 

FOLLOW-UP RECOMMENDATIONS

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

  • May need long-term rehabilitative care

  • Most patients get a follow-up MRI and/or...

REFERENCES

1
Brouwer  MC, Tunkel  AR, McKhann  GMJr, et al. Brain abscess. N Engl J Med.  2014;371(5):447–456. [View Abstract on OvidMedline]
2
...

CODES

ICD10

  • A54.82 Gonococcal brain abscess

  • G09 Sequelae of inflammatory diseases of central nervous system

  • G06.0 Intracranial abscess and granuloma

  • A06.6 Amebic brain abscess

  • B43.1 Pheomycotic brain absce...

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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