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Brain Abscess

A brain abscess can form in the brain when bacteria or fungi that get dislodged elsewhere in the body and travel through the blood stream or through veins from facial areas into the brain.

This is particularly dangerous in patients whose immune system is already weakened such as in AIDS patients (thanks to www.sciencephoto.com for this image) or drug addicts who use intravenous narcotics, as dirty needles can be the cause of a brain abscess.

However, it can also be caused from a chronic sinus infection or ear infection that involves the cranial bone. Other illnesses such as infected lungs (bronchiectases, bad pneumonia) or heart valve disease (with endocarditis) can also be an underlying cause.

Brain abscess symptom

One of the first symptoms may be a headache, nausea and vomiting. The patient may experience a personality change, be drowsy or get a sudden seizure.

At the same time there are fevers and chills and the blood test shows signs of an infection. The patient should be brought to the Emergency Room of a hospital where the physician likely will order several tests. A lumbar puncture is usually required in this setting to obtain a sample of cerebrospinal fluid for culturing of the causative organism. Other tests such as an emergency CT scan or MRI scan can be very helpful.

Treatment

Intravenous antibiotics are usually started right away after the lumbar puncture and some blood cultures have been taken. As the abscess may be walled off and the antibiotic may not penetrate into the center of it, a neurosurgeon may have to be consulted to either drain the abscess with a needle through a Burr hole or through open surgery (craniotomy). Mortality is often high depending on the other underlying factors mentioned above (Ref. 3, 1440). Here is an MRI scan image (thanks to neuropathology-web.org for this image) of a brain abscess. In the right side of the image there is a roundish lesion from a brain abscess.

Brain Abscess (Lumbar Puncture Done Before Treatment)

Brain Abscess (Lumbar Puncture Done Before Treatment)

 

References:

1. Goldman: Cecil Textbook of Medicine, 21st ed.,2000, W. B. Saunders Company

2. B. Sears: “The top 100 zone foods”. Regan Books, Harper Collins,   2001.

3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 176.

4. Noble: Textbook of Primary Care Medicine, 3rd ed.,2001, Mosby, Inc.

5. Goroll: Primary Care Medicine, 4th ed.,2000, Lippincott Williams & Wilkins

6.Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th ed., 1998, Mosby-Year Book, Inc.

7. Ruddy: Kelley’s Textbook of Rheumatology, 6th ed.,2001, W. B. Saunders Company

8. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

9. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

10. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008

Last modified: November 10, 2014

Disclaimer
This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.