Brain abscess Flashcards
What are different types of brain abscess?
lesion can be single or multi-focal
What are possible causes of brain abscess?
- Bacterial
- Fungal
- Parasitic
What is the usual epid for brain abscess?
under 30 male or paediatric 4-7years
What are RF for brain abscess?
- Sinusitis
- Otitis media
- Recent dental procedure or infection
- Meningitis
- HIV
- DM
- Recent neurosurgery
- lots of others
What are symptoms and signs for brain abscess?
- Meningismus
- Headache
- Cranial nerve palsy (3rd or 6th)
- Positive Kernig or Brudzinski sign
- Fever
- Increased head cirumference
- Bulging fontanelles
What are DDx for brain abscess?
- Primary central nervous sytem neoplasm
- Metastatic lesion
- Recurrent tumour/radiation necrosis in post surgical patient
- MS
- Acute disseminated encephalomyelitis
- Ischaemic stroke
What investigations may be used for brain abscess?
- FBC
- ESR
- Serum CRP
- Serum PT and PTT
- Blood culture
- Serum toxoplasma titre
- MRI with contrast
- CT head with and without contrast
- US head infants
What may you see on FBC for brain abscess?
leukocytosis
What are ESR levels for brain abscess?
elevated
What are serum CRP levels for brain abscess?
elevated
What are serum PT and PTT levels like in brain abscess?
normal
What may be seen on MRI with contrast with brain abscess?
one or more ring-enhancing lesion
What is the management plan for brain abscess?
- 1st line: empiric antibiotic therapy and anticonvulsants
- Corticosteroid
- Urgent surgical decompression
- Or antiparasitic or antifungal if confirmed
What complications are possible for brain abcess/
- Ventriculitis
- Hyponatraemia
- Cognitive dysfunction in children or neonates
- Seizures
- Death
- Hydrocephalus
