Brain abscess causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

The majority of cases of brain abscess are due to infections with either bacteria or fungi. Common causes of brain abscess include Cryptococcus neoformans, Staphylococcus aureus, Toxoplasma gondii, and Viridans streptococci.

Causes

Brain abscesses commonly occur when bacteria or fungi infect part of the brain. The source of the infection is often not found. However, the most common source is a lung infection. The germs that cause a brain abscess usually reach the brain through the blood. Less often, a heart infection is to blame. Germs may also travel from a nearby infected area (for example, an ear infection) or enter the body during an injury (such as a gun or knife wound) or surgery. In children with heart disease or a birth defect, such as those with tetralogy of fallot, infections are more able to reach the brain from the intestines, teeth, or other body areas.

Life Threatening Causes

Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular	Atrial septal defect, bacterial endocarditis, cyanotic congenital heart disease, Ebstein's anomaly of the tricuspid valve, endocarditis, infective endocarditis, prosthetic heart valve, pulmonary arteriovenous malformation, ventricular septal defect
Chemical/Poisoning	No underlying causes
Dental	Dental braces, dental extraction, dental sepsis, tooth infection
Dermatologic	Hereditary hemorrhagic telangiectasia, Osler-Weber-Rendu syndrome
Drug Side Effect	Chronic steroid use, intravenous drug use
Ear Nose Throat	Cholesteatoma, ear infection, hereditary hemorrhagic telangiectasia, mastoiditis, Osler-Weber-Rendu syndrome, sinusitis, suppurative otitis media
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	Amebic dysentery, cystic fibrosis, intra-abdominal infection
Genetic	Cystic fibrosis, hereditary hemorrhagic telangiectasia, Osler-Weber-Rendu syndrome
Hematologic	No underlying causes
Iatrogenic	Esophageal dilatation, neurosurgery, organ transplant, ventriculoperitoneal shunt
Infectious Disease	Actinobacillus actinomycetemcomitans, actinomyces, actinomycosis, aggregatibacter actinomycetemcomitans, amebic dysentery, amoebiasis, anaerobic bacteria, aspergillosis, aspergillus, bacterial endocarditis, bacterial meningitis, bacteroides, candida albicans, Chagas disease, cladosporium trichoides, clostridium, coccidioides immitis, congenital listeriosis, corynebacterium, cryptococcus neoformans, curvularia, cysticercosis, empyema, endocarditis, entamoeba histolytica, enterobacter, enterobacteriaceae, enterococcus, erysipelothrix rhusiopathiae, escherichia coli, fungi, fusobacterium, group B streptococcal infection, haemophilus aphrophilus, haemophilus, HIV, infective endocarditis, intra-abdominal infection, klebsiella pneumoniae, klebsiella, Lemierre's syndrome, listeria, listeriosis, lung abscess, mastoiditis, mucorales, mucormycosis, mycobacterium tuberculosis, mycoplasma hominis, nocardia, nocardiosis, opportunistic infections, orbital cellulitis, paragonimus, parasites, peptococcus, peptostreptococcus, prevotella, propionibacterium, proteus, pseudomonas, pyomyositis, rhodococcus equi, salmonella, scedosporium apiospermum, schistosoma japonicum, sinusitis, staphylococcus aureus, staphylococcus epidermidis, streptococcus milleri, streptococcus pneumoniae, streptococcus, suppurative otitis media, tooth infection, toxoplasma, upper respiratory tract infections, urinary tract infection, viridans streptococci, wound infections
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Bacterial meningitis, brain surgery, brain tumor, cholesterol granuloma, foreign body aspiration, hereditary hemorrhagic telangiectasia , neurological disorders related to AIDS, neurosurgery, Osler-Weber-Rendu syndrome, skull fracture, traumatic brain injury
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	Brain tumor, cholesterol granuloma, hematogenous spread, neoplasms
Ophthalmologic	Orbital cellulitis
Overdose/Toxicity	Chronic steroid use, drug abuse, intravenous drug abuse
Psychiatric	No underlying causes
Pulmonary	Bronchiectasis, cystic fibrosis, empyema, foreign body aspiration, lung abscess, mycobacterium tuberculosis, upper respiratory tract infections
Renal/Electrolyte	Urinary tract infection
Rheumatology/Immunology/Allergy	Immunodeficiency
Sexual	No underlying causes
Trauma	Head trauma, penetrating head trauma, puncture wound to brain, skull fracture, traumatic brain injury
Urologic	Urinary tract infection
Miscellaneous	Alcoholism, near drowning, ventriculoperitoneal shunt

Causes in Alphabetical Order

3

References

↑ Saghrouni F, Ben Youssef Y, Gheith S, Bouabid Z, Ben Abdeljelil J, Khammari I; et al. (2011). "Twenty-nine cases of invasive aspergillosis in neutropenic patients". Med Mal Infect. 41 (12): 657–62. doi:10.1016/j.medmal.2011.09.011. PMID 22036518.
↑ ^2.0 ^2.1 Wu PC, Tu MS, Lin PH, Chen YS, Tsai HC (2014). "Prevotella brain abscesses and stroke following dental extraction in a young patient: a case report and review of the literature". Intern Med. 53 (16): 1881–7. PMID 25130130.
↑ Clifton TC, Kalamchi S (2012). "A case of odontogenic brain abscess arising from covert dental sepsis". Ann R Coll Surg Engl. 94 (1): e41–3. doi:10.1308/003588412X13171221499667. PMC 3954226. PMID 22524927.CS1 maint: PMC format (link)
↑ ^4.0 ^4.1 Sveinsson OA, Asgeirsson H, Olafsson IH (2013). "[Brain abscess - overview]". Laeknabladid. 99 (1): 25–31. PMID 23341403.
↑ ^5.0 ^5.1 ^5.2 Patel K, Clifford DB (2014). "Bacterial brain abscess". Neurohospitalist. 4 (4): 196–204. doi:10.1177/1941874414540684. PMC 4212419. PMID 25360205.CS1 maint: PMC format (link)
↑ Cano P, Horseman MA, Surani S (2010). "Rhinocerebral mucormycosis complicated by bacterial brain abscess". Am J Med Sci. 340 (6): 507–10. doi:10.1097/MAJ.0b013e3181f0aad1. PMID 20861715.
↑ Mays R, Gordon R, Wilson JM, LaPolla WJ, Sra KK, Madkan V; et al. (2012). "Persistent erythematous plaque after minor trauma in an immunocompromised woman". Dermatol Online J. 18 (4): 2. PMID 22559017.

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[pmid22036518-1] Saghrouni F, Ben Youssef Y, Gheith S, Bouabid Z, Ben Abdeljelil J, Khammari I; et al. (2011). "Twenty-nine cases of invasive aspergillosis in neutropenic patients". Med Mal Infect. 41 (12): 657–62. doi:10.1016/j.medmal.2011.09.011. PMID 22036518.

[pmid25130130-2] 2.0 ^2.1 Wu PC, Tu MS, Lin PH, Chen YS, Tsai HC (2014). "Prevotella brain abscesses and stroke following dental extraction in a young patient: a case report and review of the literature". Intern Med. 53 (16): 1881–7. PMID 25130130.

[pmid22524927-3] Clifton TC, Kalamchi S (2012). "A case of odontogenic brain abscess arising from covert dental sepsis". Ann R Coll Surg Engl. 94 (1): e41–3. doi:10.1308/003588412X13171221499667. PMC 3954226. PMID 22524927.CS1 maint: PMC format (link)

[pmid23341403-4] 4.0 ^4.1 Sveinsson OA, Asgeirsson H, Olafsson IH (2013). "[Brain abscess - overview]". Laeknabladid. 99 (1): 25–31. PMID 23341403.

[pmid25360205-5] 5.0 ^5.1 ^5.2 Patel K, Clifford DB (2014). "Bacterial brain abscess". Neurohospitalist. 4 (4): 196–204. doi:10.1177/1941874414540684. PMC 4212419. PMID 25360205.CS1 maint: PMC format (link)

[pmid20861715-6] Cano P, Horseman MA, Surani S (2010). "Rhinocerebral mucormycosis complicated by bacterial brain abscess". Am J Med Sci. 340 (6): 507–10. doi:10.1097/MAJ.0b013e3181f0aad1. PMID 20861715.

[pmid22559017-7] Mays R, Gordon R, Wilson JM, LaPolla WJ, Sra KK, Madkan V; et al. (2012). "Persistent erythematous plaque after minor trauma in an immunocompromised woman". Dermatol Online J. 18 (4): 2. PMID 22559017.