Brain Abscess

Question 1

Cerebritis ?

Answer 1

Nonencapsulated brain abscess

Question 2

Etiology of brain abscess in immunocompetent

Answer 2

1-Strep 40%
2-Enterobacteriaceae Proteus, E coli, klebsiella 25%
3-Anaerobes (eg Bacteroides spp, Fusobacterium spp) 30%
4- Staph

Question 3

Etiology of brain in immunocompromised

Answer 3

Nocardia spp, toxoplasmosis, aspergillus, Candida, criptocrccus neoformans

Question 4

Otogenic abscesses

Answer 4

1/3
Dominantly in temporal lobe and cerebellum
Up to 90% of cerebellar abscesses are otogenic
Common etiology: strep, bacteroides, pseudomonas, haemophilus, enterobacteriaceae

Question 5

Abscesses secondary to sinuses or dental infection are usually located in

Answer 5

Frontal lobes

Question 6

Treatment of brain abscess

Answer 6

3rd or 4th cephalosporins and metronidazole + penicillin G/vancomycin I

+ for penetrating trauma or recent neurosurgical procedure, procedure should include ceftazidime for pseudomonas and vancomycin for MRSA

Question 7

Treatment of nosocomial brain abscesses:

Answer 7

Vancomycin + ceftazidime+ metronidazole
Or meropenem + vancomycin

Duration 6-8 weeks

Question 8

Most spinal epidural abscesses occur in ?

Answer 8

Thoracic area

Question 9

Most common pathogen in spinal epidural abscess:

Answer 9

Staph aureus

Others: pseudomonas E coli brucella tb mrsa