Brain abscess

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Diagnosis

History and Symptoms | Physical Examination | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics

Treatment

Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future therapies

Prognosis

Once an almost always fatal disease before the CT era. If the abscess is treated before the person goes into a coma then the death rate has been estimated from 5% to 20%.

Early treatment and the patients overall health has an effect on prognosis. Other factors include: antibiotic resistance or the abscess location. An abscess deep within the brain is more difficult to treat than others.

In general

• Mortality is currently quoted to range from 0 – 24%.

• Poor prognostic indicators include:

• Intraventricular rupture:

• 80% mortality rate, often treated with open drainage and debridement f/b ventriculostomy catheter for drainage and intrathecal abx

• Mental status and neurologic function at time of Dx:

• The most common sequellae is seizures, which develop in 35 – 70% of patients.

Additional Resources

Mathisen, G.E., Johnson, J.P., Brain abscess, Clin Infectious Disease 1997; 25: 763-781.