Edit concept Question Editor Create issue ticket

Intracranial Abscess


Presentation

  • Abstract The bacteriological and clinical findings in 19 pediatric patients with intracranial abscess are presented. Ten children presented with subdural empyema and nine had brain abscess.[ncbi.nlm.nih.gov]
Fever
  • The patient experienced photophobia, fever, headache, nausea and vomiting. Frontal sinusitis with intracranial abscess was diagnosed on imaging. The patient was taken to the operating room for drainage with left frontal balloon sinuplasty.[ncbi.nlm.nih.gov]
  • Common presenting symptoms include fever, headache, changes in mental state (drowsiness, confusion), focal neurological deficits, grand mal seizures, nausea and vomiting, neck stiffness.[patient.info]
  • […] scan (a and b) of a 60-year-old male with fever, headache, and eyeball swelling revealed sinusitis with cavernous sinus invasion.[e-fjs.org]
  • Signs and symptoms [ edit ] Fever, headache, and neurological problems, while classic, only occur in 20% of people with brain abscess. [2] The famous triad of fever, headache and focal neurologic findings are highly suggestive of brain abscess.[en.wikipedia.org]
  • Fever, chills, and leukocytosis may develop before the infection is encapsulated, but they may be absent at presentation or subside over time.[merckmanuals.com]
Malaise
  • Clinical features: The earliest stage where the brain tissue is invaded (stage of encephalitis) is marked by the presence of headache, fever, malaise and vomiting. Drowsiness eventually follow.[sites.google.com]
  • Symptoms include fever, malaise, irritability, severe headache, convulsions, vomiting, and other signs of intracranial hypertension.[medical-dictionary.thefreedictionary.com]
Headache
  • The patient experienced photophobia, fever, headache, nausea and vomiting. Frontal sinusitis with intracranial abscess was diagnosed on imaging. The patient was taken to the operating room for drainage with left frontal balloon sinuplasty.[ncbi.nlm.nih.gov]
  • Volume 1 covers the visual sensory system, the autonomic nervous system, the ocular motor system, the eyelid, facial pain and headache, and nonorganic disease. Volume 2 covers tumors, the phacomatoses, and vascular disease.[books.google.com]
  • A suddenly worsening headache, followed by emerging signs of meningism, are often associated with rupture of the abscess. Signs Fever. Focal motor or sensory deficits.[patient.info]
  • […] scan (a and b) of a 60-year-old male with fever, headache, and eyeball swelling revealed sinusitis with cavernous sinus invasion.[e-fjs.org]
Altered Mental Status
  • mental status), and blood cultures.[emdocs.net]
  • Seizures and neck stiffness may be seen in some patients Focal motor and sensory neurological deficits, along with altered mental status are common If the abscess is located in the cerebellum (small brain) - nystagmus (erratic movement of eyeball with[dovemed.com]
  • From the lesson Altered Mental Status, Brain Death, & Central Nervous System Infections The description goes here Meet the Instructors Daniel Lowenstein, MD Professor and Vice Chair, Department of Neurology School of Medicine S.[coursera.org]
  • These include headaches, found in up to 85% of cases, nausea and vomiting, papilledema, and altered mental status. [3], [12], [13] The triad of fever, focal neurological deficit, and headaches is found in less than half of the patients. [12] The neuropathological[asianjns.org]
  • Patients who present with altered mental status have more advanced disease and have a higher mortality rate. [10] Spread beyond middle ear cleft can occur due to destruction by cholesteatoma, through fracture lines, preformed pathways, through the Haversian[indianjotol.org]
Stupor
  • If this stage progresses rapidly to generalised encephalitis before it could be contained by the formation of the capsule, drowsiness may progress to stupor and coma followed by death..[sites.google.com]
  • We do know that patients that present with rapid progression that present in stupor or coma, or have spread of infection into the ventricles tend to have a poor prognosis.[coursera.org]
  • It is unusual to require an emergent neurosurgical procedure for abscess, but a consultation should be considered if the patient has severe mass effect, is comatose, stuporous or has a capsule larger than 2 cm. B.[clinicaladvisor.com]
  • The mental status for patients was classified into two groups: (i) clear consciousness; and (ii) inattention, confusion, clouded consciousness, stupor, or coma. Surgical intervention and/or antibiotic therapy were the mainstays of our treatment.[academic.oup.com]
Lethargy
  • Headache, nausea, vomiting, lethargy, seizures, personality changes, papilledema, and focal neurologic deficits develop over days to weeks; fever may be absent at presentation.[merckmanuals.com]
  • He displayed an acute onset of confusion, lethargy, unstable gait and neck stiffness. Magnetic resonance imaging investigations ( Figs. 2a and 2b ) revealed a 4.7 4.4 3.4 cm thin-walled lesion with surrounding edema in the left temporal lobe.[jcda.ca]
  • Changes in mental status occur in 65 percent of cases, and they may lead to: confusion drowsiness and lethargy irritability poor mental focus poor responsiveness slow thought processes coma (possibly) Neurologic difficulties affect 50–65 percent of people[medicalnewstoday.com]
  • Chronic anoxia causes lethargy, weakness, blindness and sometimes convulsions.[medical-dictionary.thefreedictionary.com]

Workup

  • It is necessary to perform anaerobic cultures along with routine aerobic cultures as a part of microbiological workup of abscess aspirates in patients with brain abscess which aid in providing appropriate antibiotic therapy.[casereports.in]
Mycobacterium Avium Complex
  • Mycobacterium avium complex (MAC) is a ubiquitous pathogen, widely distributed in the environment including water, soil and animals.[ncbi.nlm.nih.gov]

Treatment

  • OBJECTIVE: To evaluate the treatment of intracranial abscess of otogenic origin, and to study the outcome measures of single stage treatment of the otogenic focus and drainage of intracranial abscess via a transmastoid approach.[ncbi.nlm.nih.gov]

Prognosis

  • Central nervous system (CNS) infections due to MAC are exceedingly rare and carry a poor prognosis. Additionally, such infections are largely reported in patients infected with HIV.[ncbi.nlm.nih.gov]
  • Prognosis [ 8 ] Mortality ranges between 17% and 32%. Poor prognosis is reported in patients who are immunocompromised, have diabetes mellitus or cirrhosis and presentation with a low Glasgow Coma Score.[patient.info]
  • (Outcomes/Resolutions) Multiple Brain Abscesses and abscesses located deep within brain tissue are associated with bad prognosis When the patient presents with coma or advanced neurological damage, it indicates an unfavorable prognosis.[dovemed.com]
  • Prognosis is most closely related to the patient's neurological status at presentation.[bestpractice.bmj.com]

Etiology

  • These findings indicate the major role of anaerobic organisms in the polymicrobial etiology of intracranial abscess in children.[ncbi.nlm.nih.gov]
  • These disorders share many diagnostic and therapeutic similarities and, frequently, very similar etiologies.[uhms.org]
  • Community-acquired brain abscess in Taiwan: etiology and probable source of infection. J Microbiol Immunol Infect 37, 231 –235. [Google Scholar] Osma, U., Cureoglu, S. & Hosoglu, S. ( 2000 ; ).[jmm.microbiologyresearch.org]
  • A diagnosis of left temporal lobe abscess secondary to otogenic etiology was made.[casereports.in]
  • In their retrospective study, they examined 194 patient charts and imaging studies, and they concluded that the detection of cytosolic amino acids is a strong indication of an abscess of pyogenic origin, without ruling out nonpyogenic etiology.[ajnr.org]

Epidemiology

  • The occurrence of CA-MRSA and LA-MRSA infection in the central nervous system signifies the threat from the community and livestock reservoir, thus drawing attention towards surveillance and tracking to understand the epidemiology and implement infection[ncbi.nlm.nih.gov]
  • Epidemiology Incidence is estimated at 0.3-1.3 per 100,000 people per year (non-HIV infected). [ 1 ] Intracranial abscess, although uncommon, have relatively higher occurrence in low socio-economic settings where previous antibiotic abuse and lack of[patient.info]
  • The purpose of this study is to describe the epidemiology of BA in Taiwan and to investigate potential factors affecting the survival of patients with BA.[journals.plos.org]
  • Epidemiology of brain abscess in Taiwan: A 14-year population-based cohort study. PLoS One. 2017. 12:e0176705. [Medline]. Tseng JH, Tseng MY. Brain abscess in 142 patients: factors influencing outcome and mortality.[reference.medscape.com]
  • Microbiology and epidemiology of brain abscess and subdural empyema in a medical centre: A 10 years experience. J Microbiol Immunol Infect 2009;42:405-12. 28. Yoshikawa TT, Goodman SJ.[asianjns.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology [ edit ] Bacterial [ edit ] Brain abscess after metastasis treatment. Anaerobic and microaerophilic cocci and gram-negative and gram-positive anaerobic bacilli are the predominate bacterial isolates.[en.wikipedia.org]
  • Brain abscess as a complication of orthognathic surgery: diagnosis, management and pathophysiology. Plast Reconstr Surg. 1999;104(2):480-2. Nishihara J, Takeuchi Y, Miki T, Itoh M, Nagahata S. Anatomical study on valves of human facial veins.[jcda.ca]
  • Pathophysiology Brain abscess is caused by intracranial inflammation with subsequent abscess formation.[reference.medscape.com]
  • Tuberculous brain abscess: clinical presentation, pathophysiology and treatment (in children). Child’s Nervous System April 2002, vol 18, Issue 3-4, pp 118-123. [ [pubmed][npplweb.com]
  • Pathogenesis and pathophysiology of bacterial infections. In: Scheld WM, Whitley RJ, Durack, DT, eds. Infections of the Central Nervous System, tind ed. Philadelphia: Lippincott-Raven; 1997;297-312; and Britt RH, Enzmann DR, Yeager AS.[slideshare.net]

Prevention

  • Abstract One-and-a-half per cent of adults have active chronic otitis media and its management to prevent complications is a considerable workload.[ncbi.nlm.nih.gov]
  • A key factor in preventing Brain Abscesses is to reduce the risks for this condition.[dovemed.com]
  • Prevention is important. You can lower your risk by monitoring any conditions that can cause a brain abscess. Call your doctor at the first sign of a brain abscess.[healthline.com]
  • Prevent HIV by practicing safe sex. If you have HIV, you substantially reduce your chance of developing a brain abscess by taking anti-viral medications regularly.[drugs.com]
  • The pressure from the abscess can block blood vessels, preventing oxygen from reaching the brain, and this results in damage or destruction of delicate brain tissue.[medicalnewstoday.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!