Brain abscesses and CNS infections Flashcards Preview

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Flashcards in Brain abscesses and CNS infections Deck (14):
1

Causes of brain abscess

Often polymicrobial

Streptococci
Staph aureus
Anaerobes
Gram -ve entero bacteria
Fungi

2

4 ways brain abscess can develop

Direct spread from ear, sinus, teeth...
Haematogenous e.g. endocarditis, brinchiectasis
Trauma
Cryptogenic- more common in immunocompromised

3

Presentation of brain abscess

Headache
Focal neurological defecit
Confusion
Fever
Nausea and vomiting
Dizziness, seizures
Neck stiffness
Late signs- papilloedema and seizures

4

How to Dx brain abscess?

Imaging

5

Management of brain abscess?

Drainage to reduce ICP, confirm Dx, obtain microbiology pus sample, enhance efficacy of antibiotics and to avoid spread of infection to ventricles.

6

6 antibiotics used to treat brain abscess

Ampicillin
Benzyl-penicillin
Cefuroxime
Cefotaxime
Ceftazidime
Metronidazole

7

Complications of brain abscess

Raised ICP
Mass effect
coning
Rupture causing ventriculitis

8

Causes of subdural empyema

Often polymicrobial
Anaerobes
Streptococci
Aerobic gram -ve

9

Pathogenesis of subdural empyema

Spread from sinuses, middle ear and mastoid or distant site, or following surgery or trauma

10

Presentation of subdural empyema

Headache
Fever
Focal neurological defecit
Confusion
Seizure
Coma

11

Management of subdural empyema

Drain pus
Antimicrobial agents guided by microbiology of pus

12

What might be the function of a ventriculoperitoneal shunt or an external ventricular drain?

Monitor ICP or drain excess CSF

13

What most commonly colonises VPs and EVDs?

Coagulase negative staphylococci- normal skin flora

14

Rx of VP/EVD infection?

Device removal, IV Abx