Brain abscess: Difference between revisions

Revision as of 16:50, 21 June 2016

Caused by one of three methods:
- Hematogenous spread (33%)
- Contiguous infection from middle ear, sinus, teeth (33%)
- Direct implantation by surgery or penetrating trauma (10%)
Microbiology
- Anaerobes and Gram-negative rods are typical pathogens
- Staph is involved with direct implantation cases

Pts rarely appear acutely ill
Classic traid of HA, fever, AND focal neuro deficit is present in <33%
- Headache is most common symptom (present in almost all cases)
- Fever (~50% of patients)
Focal neuro symptoms or seizure (~33% of patients)
Neck stiffness (<50% of patients)
Signs of increased ICP: vomiting, confusion, obtundation (50% of patients)

CT with contrast
- Ring enhancing lesion surrounding low-density center surrounded by white matter edema
- Early in course ring may be less defined; CT may only show area of focal hypodensity

Authors:

@@ Line 12: / Line 12: @@
 *Classic traid of HA, fever, AND focal neuro deficit is present in <33%
 **Headache is most common symptom (present in almost all cases)
-**Fever (~50% of pts)
+**Fever (~50% of patients)
-*Focal neuro symptoms or seizure (~33% of pts)
+*Focal neuro symptoms or seizure (~33% of patients)
-*Neck stiffness (<50% of pts)
+*Neck stiffness (<50% of patients)
-*Signs of increased ICP: vomiting, confusion, obtundation (50% of pts)
+*Signs of increased ICP: vomiting, confusion, obtundation (50% of patients)
 ==Differential Diagnosis==