Brain Abscess

Epidemiology and Risk Factors

Pathophysiology

Infective spread from:

  • Bone
  • Dura
  • Bacteraemia

Aetiology

Oragnisms include:

  • Common
    • S. Aureus
    • Streptococcus spp.
    • Bacteroides fragilis
    • Assorted Gram negatives

Clinical Manifestations

Feature include:

  • ↑ ICP
    • Obtundation
  • Mass lesion
    • Headache
    • Vomiting
    • Obtundation
    • Seizures

Notably, meningism is often absent.

Diagnostic Approach and DDx

Investigations

Bedside:

Laboratory:

Imaging:

Other:

Management

Resuscitation:

ABC approach. Comment on team coordination and clinical priorities. Specific therapy:

  • Pharmacological
  • Procedural
  • Physical

Supportive care:

Disposition:

Marginal and Ineffective Therapies

Anaesthetic Considerations

Complications

Prognosis

Key Studies

References

  1. Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.