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International Journal of Surgery... 2011Intracranial abscess is a formidable entity. Despite the advent of newer antibiotics and surgical strategies, the overall outcome and quality of life issues in brain... (Review)
Review
Intracranial abscess is a formidable entity. Despite the advent of newer antibiotics and surgical strategies, the overall outcome and quality of life issues in brain abscess patients still remain a continuous challenge for the neurosurgical community. It is a direct interplay between the virulence of the offending microorganism and the immune response of the host. An analysis of our experience in the 289 cases of surgically treated pyogenic brain abscess is presented along with an overview of intra-cranial abscess of varied etiology and in different locations. The etiology, pathogenesis, radiological advances and treatment modalities of brain abscess are discussed in light of current literature.
Topics: Anti-Bacterial Agents; Anticonvulsants; Brain Abscess; Diffusion Magnetic Resonance Imaging; Humans; Magnetic Resonance Spectroscopy; Neurosurgical Procedures
PubMed: 21087684
DOI: 10.1016/j.ijsu.2010.11.005 -
The New England Journal of Medicine Jul 2014
Review
Topics: Anti-Infective Agents; Brain Abscess; Combined Modality Therapy; Humans; Stereotaxic Techniques; Suction
PubMed: 25075836
DOI: 10.1056/NEJMra1301635 -
Child's Nervous System : ChNS :... Jul 2019The purpose of the paper is to examine the current state of the art about epidemiology, diagnosis, and treatment of this infection. (Review)
Review
OBJECTIVE
The purpose of the paper is to examine the current state of the art about epidemiology, diagnosis, and treatment of this infection.
METHODS
A review of the literature was performed through a PubMed search of original articles, case reports, and reviews using the key words "brain abscess," "cerebral abscess," "brain infection," "intracranial suppuration," "otogenic brain abscess," "otitis complications," and "sinusitis complications."
RESULTS
Pediatric brain abscess is a rare but serious infection, often involving patients with specific risk factors and burdened by a high risk of morbidity and mortality. Brain abscess incidence and mortality decreased over the years, thanks to improved antibiotic therapy, new neurosurgical techniques, and the wide spread of vaccinations. There are no guidelines for the adequate diagnostic-therapeutic pathway in the management of brain abscesses; therefore, conflicting data emerge from the literature. In the future, multicentric prospective studies should be performed in order to obtain stronger evidences about brain abscesses management. Over the next few years, changes in epidemiology could be observed because of risk factors changes.
Topics: Anti-Bacterial Agents; Brain Abscess; Child; Humans; Neuroimaging; Neurosurgical Procedures
PubMed: 31062139
DOI: 10.1007/s00381-019-04182-4 -
Clinical Microbiology and Infection :... Sep 2017A brain abscess is a focal infection of the brain that begins as a localized area of cerebritis. In immunocompetent patients, bacteria are responsible for >95% of brain... (Review)
Review
BACKGROUND
A brain abscess is a focal infection of the brain that begins as a localized area of cerebritis. In immunocompetent patients, bacteria are responsible for >95% of brain abscesses, and enter the brain either through contiguous spread following otitis, sinusitis, neurosurgery, or cranial trauma, or through haematogenous dissemination.
AIMS
To identify recent advances in the field.
SOURCES
We searched Medline and Embase for articles published during years 2012-2016, with the keywords 'brain' and 'abscess'.
CONTENT
The triad of headache, fever and focal neurological deficit is complete in ∼20% of patients on admission. Brain imaging with contrast-preferentially magnetic resonance imaging-is the reference standard for diagnosis, and should be followed by stereotactic aspiration of at least one lesion, before the start of any antimicrobials. Efforts should be made for optimal management of brain abscess samples, for reliable microbiological documentation. Empirical treatment should cover oral streptococci (including milleri group), methicillin-susceptible staphylococci, anaerobes and Enterobacteriaceae. As brain abscesses are frequently polymicrobial, de-escalation based on microbiological results is safe only when aspiration samples have been processed optimally, or when primary diagnosis is endocarditis. Otherwise, many experts advocate for anaerobes coverage even with no documentation, given the sub-optimal sensitivity of current techniques. A 6-week combination of third-generation cephalosporin and metronidazole will cure most cases of community-acquired brain abscess in immunocompetent patients.
IMPLICATIONS
Significant advances in brain imaging, minimally invasive neurosurgery, molecular biology and antibacterial agents have dramatically improved the prognosis of brain abscess in immunocompetent patients over the last decades.
Topics: Anti-Infective Agents; Brain Abscess; Drainage; Humans; Neurosurgical Procedures
PubMed: 28501669
DOI: 10.1016/j.cmi.2017.05.004 -
Critical Care Nursing Clinics of North... Sep 2013A brain abscess is defined as a localized collection of pus within the parenchyma of the brain or meninges. Brain abscesses are a complication of ear, sinus, and/or... (Review)
Review
A brain abscess is defined as a localized collection of pus within the parenchyma of the brain or meninges. Brain abscesses are a complication of ear, sinus, and/or dental infections. Although they may occur in many brain locations, the most common sites are frontal and temporal lobes. Modern neuroimaging and laboratory analysis have led to prompt diagnosis and have decreased the mortality rates from brain abscess. Critical care nurses have a vital role in performing accurate neurologic assessments, timely administration of antibiotics, and management of fever.
Topics: Anti-Bacterial Agents; Brain Abscess; Central Nervous System Infections; Critical Care Nursing; Cross Infection; Humans; Magnetic Resonance Imaging; Paranasal Sinus Diseases; Tomography, X-Ray Computed
PubMed: 23981454
DOI: 10.1016/j.ccell.2013.04.001 -
Revue Neurologique 2019Brain abscess is a focal infection of the brain due to contiguous spread of pathogens following otitis, sinusitis, neurosurgery or traumatic brain injury or through... (Review)
Review
Brain abscess is a focal infection of the brain due to contiguous spread of pathogens following otitis, sinusitis, neurosurgery or traumatic brain injury or through hematogenous dissemination. Classical symptoms consisting of headache, fever, and focal signs may be absent on admission and brain MRI with contrast plays a major role in diagnosis. Initial management consists of stereotactic aspiration for microbiological documentation empirical treatment covering common pathogens, including oral streptococci, staphylococci, anaerobes, and Enterobacteriaceae. De-escalation of antimicrobials based on microbiology is safe only when samples have been processed optimally, or when primary diagnosis is endocarditis. A 6-week combination of third-generation cephalosporin and metronidazole will cure most cases of community-acquired brain abscess in immunocompetent adults. Significant advent in brain imaging, minimally invasive surgery, molecular biology, and antibacterial agents, has dramatically improved the prognosis. Main indicators of outcome include altered mental status at presentation and intraventricular rupture.
Topics: Adult; Brain Abscess; Humans; Immunocompetence
PubMed: 31447060
DOI: 10.1016/j.neurol.2019.07.002 -
Clinical Infectious Diseases : An... Oct 1997The past 20 years have seen major advances in the diagnosis and management of brain abscess, with a corresponding improvement in the survival rates. The advances in... (Review)
Review
The past 20 years have seen major advances in the diagnosis and management of brain abscess, with a corresponding improvement in the survival rates. The advances in radiographic scanning, the availability of new antimicrobials, and the development of novel surgical techniques have all contributed to the decreases in associated morbidity and mortality. The relative rarity of brain abscess and the frequent delays in making the diagnosis render this condition a significant challenge for the clinician. A high index of suspicion is required so that effective therapy can be instituted as soon as possible. Close coordination of care between neurosurgeons and infectious diseases specialists is increasingly important in the complicated management of brain abscess. Adequate abscess drainage and appropriate antimicrobial therapy remain the cornerstones of proper treatment of this condition.
Topics: AIDS-Related Opportunistic Infections; Anti-Infective Agents; Brain Abscess; Cerebellar Diseases; Combined Modality Therapy; Humans; Magnetic Resonance Imaging; Mycoses; Nocardia Infections; Survival Rate; Tuberculosis
PubMed: 9356788
DOI: 10.1086/515541 -
Seminars in Neurology 2000The epidemiology of brain abscess has changed with the increasing incidence of this infection in immunocompromised patients, particularly solid organ and bone marrow... (Review)
Review
The epidemiology of brain abscess has changed with the increasing incidence of this infection in immunocompromised patients, particularly solid organ and bone marrow transplant recipients, and the decreasing incidence of brain abscess related to sinusitis and otitis. A number of new neuroimaging modalities, including single photon emission computed tomography, positron emission tomography, perfusion magnetic resonance imaging, and magnetic resonance spectroscopy, provide an initial noninvasive approach to diagnosis. The recommendations for the management of intracranial mass lesions in human immunodeficiency virus-infected individuals has changed as the incidence of toxoplasmic encephalitis has decreased with the use of trimethoprim-sulfamethoxazole prophylaxis. The epidemiology, pathogenesis, microbiology, clinical presentation, diagnosis, treatment and prognosis of brain abscess in the beginning of the 21 st century are provided in this review.
Topics: Brain; Brain Abscess; Humans; Radiography
PubMed: 11051299
DOI: 10.1055/s-2000-9397 -
Clinical Neuropharmacology Dec 1987
Review
Topics: Anti-Bacterial Agents; Brain Abscess; Diagnosis, Differential; Humans; Prognosis
PubMed: 3322554
DOI: 10.1097/00002826-198712000-00001 -
The Western Journal of Medicine Sep 1974
Review
Topics: Adolescent; Adult; Age Factors; Anti-Bacterial Agents; Autopsy; Brain Abscess; Carotid Artery, Internal; Child; Cranial Fossa, Posterior; Craniotomy; Ear Diseases; Heart Defects, Congenital; Heart Septal Defects; Humans; Infant; Male; Mastoiditis; Middle Aged; Pseudotumor Cerebri; Radiography; Respiratory Tract Infections; Skull
PubMed: 4606285
DOI: No ID Found