Brain abscess

Question 1

(single brain abscess) microbiology?

Answer 1

staphylococcus aureus, viridans sterptococci

anaerobes

Question 2

pathogenesis?

Answer 2

direct spread ( otitis media, mastoiditis, sinusitis)
Hematogenous spread ( ex: endocarditis)

Question 3

clinical findings?

Answer 3

headache, vomiting, fever, focal neurologic deficits, seizure, cerebritis initially but within 1-2 weeks a ring- enhancing lesion on neuroimaging (CT,MRI).

Question 4

treatment?

Answer 4

Aspiration/surgical drainage ( to obtain tissue for gram stain and culture), prolonged antibiotic therapy (iv, metronidazole, ceftriaxone and vancomycin)