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Flashcards in infections of CNS - brain abscess Deck (9)
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most common source of bacterial brain abscess

- pulmonary pathology, particularly bronchiectasis
- cyanotic congenital heart disease
- arteriovenous malformations


why are congenital heart and vascular issues risk factors for brain abscess?

tend to shunt directly into left side of heart and miss filtration by pulmonary macrophage system


typical quality of bacteria that cause brain abscess

anaerobic or microaerobic (from bowel)


when are aerobic bacteria involved in brain abscess

- usually when directly connected to sinuses, middle ear, skull fractures


most like locations for hematologically spread abscesses

- areas of ischemic injury


locations of abscesses based on origin

ear infection - middle third of temporal lobe, cerebellum
sinuses and dental infections - frontal lobe
hematological - any location, often multiple


describe first stage of brain abscess and treatment

- cerebritis
- febrile, still active primary infection
- inflammation, tissue breakdown
- raised intracranial pressure
- abnormalities on imaging but no defined mass on angiography
- antibiotics alone can often resolve it


describe second stage of brain abscess and treatment

- cerebritis walls off and becomes true abscess
- afrebrile
- expanding mass
- surgical drainage may be needed


complications of untreated brain abscess

- cerebral herniation
- rupture into ventricles causing severe meningitis (WBC count over 10,000/cu mm