Brain abscess - Revision history

Rossdonaldson1: /* Background */

2023-01-25T22:29:43Z

Background

← Older revision		Revision as of 22:29, 25 January 2023
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	==Background==		==Background==
	[[File:Brainlobes.png i\|thumb\|Lobes of the brain.]]		[[File:Brainlobes.png\|thumb\|Lobes of the brain.]]
	*Caused by one of three methods:		*Caused by one of three methods:
	**Hematogenous spread (33%)		**Hematogenous spread (33%)

Rossdonaldson1: /* Background */

2023-01-25T22:29:07Z

Background

← Older revision		Revision as of 22:29, 25 January 2023
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	==Background==		==Background==
			[[File:Brainlobes.png i\|thumb\|Lobes of the brain.]]
	*Caused by one of three methods:		*Caused by one of three methods:
	**Hematogenous spread (33%)		**Hematogenous spread (33%)

Rossdonaldson1: /* Evaluation */

2020-10-27T21:52:49Z

Evaluation

← Older revision		Revision as of 21:52, 27 October 2020
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	==Evaluation==		==Evaluation==
	[[File:PMC4857327 10.1177 2050313X15591314-fig3.png\|thumb\|]]		[[File:PMC4857327 10.1177 2050313X15591314-fig3.png\|thumb\|Brain abscess on CT (arrows) with left hemiplegia.]]
	[[File:PMC3970313 ic-46-45-g001.png\|thumb\|Nocardia brain abscess on MRI. (A) T1-WI shows rim-enhancing lesion with associated edema in the right occipital lobe. (B) The dark signal on T2-WI and consistent thickness of the wall suggest a brain abscess.]]		[[File:PMC3970313 ic-46-45-g001.png\|thumb\|Nocardia brain abscess on MRI. (A) T1-WI shows rim-enhancing lesion with associated edema in the right occipital lobe. (B) The dark signal on T2-WI and consistent thickness of the wall suggest a brain abscess.]]
	*[[Head CT]] with contrast		*[[Head CT]] with contrast

Rossdonaldson1: /* Evaluation */

2020-10-27T21:51:51Z

Evaluation

← Older revision		Revision as of 21:51, 27 October 2020
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	==Evaluation==		==Evaluation==
			[[File:PMC4857327 10.1177 2050313X15591314-fig3.png\|thumb\|]]
	[[File:PMC3970313 ic-46-45-g001.png\|thumb\|Nocardia brain abscess on MRI. (A) T1-WI shows rim-enhancing lesion with associated edema in the right occipital lobe. (B) The dark signal on T2-WI and consistent thickness of the wall suggest a brain abscess.]]		[[File:PMC3970313 ic-46-45-g001.png\|thumb\|Nocardia brain abscess on MRI. (A) T1-WI shows rim-enhancing lesion with associated edema in the right occipital lobe. (B) The dark signal on T2-WI and consistent thickness of the wall suggest a brain abscess.]]
	*[[Head CT]] with contrast		*[[Head CT]] with contrast

Rossdonaldson1: /* Evaluation */

2020-10-27T21:49:20Z

Evaluation

← Older revision		Revision as of 21:49, 27 October 2020
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	==Evaluation==		==Evaluation==
	[[File:PMC3970313 ic-46-45-g001.png\|thumb\|Nocardia brain abscess on MRI. (A) T1-WI shows rim-enhancing lesion with associated edema in the right occipital lobe. (B) The dark signal on T2-WI and consistent thickness of the wall suggest a brain abscess.		[[File:PMC3970313 ic-46-45-g001.png\|thumb\|Nocardia brain abscess on MRI. (A) T1-WI shows rim-enhancing lesion with associated edema in the right occipital lobe. (B) The dark signal on T2-WI and consistent thickness of the wall suggest a brain abscess.]]
	*[[Head CT]] with contrast		*[[Head CT]] with contrast
	**Ring enhancing lesion surrounding low-density center surrounded by white matter edema		**Ring enhancing lesion surrounding low-density center surrounded by white matter edema

Rossdonaldson1: /* Evaluation */

2020-10-27T21:34:14Z

Evaluation

← Older revision		Revision as of 21:34, 27 October 2020
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	==Evaluation==		==Evaluation==
			[[File:PMC3970313 ic-46-45-g001.png\|thumb\|Nocardia brain abscess on MRI. (A) T1-WI shows rim-enhancing lesion with associated edema in the right occipital lobe. (B) The dark signal on T2-WI and consistent thickness of the wall suggest a brain abscess.
	*[[Head CT]] with contrast		*[[Head CT]] with contrast
	**Ring enhancing lesion surrounding low-density center surrounded by white matter edema		**Ring enhancing lesion surrounding low-density center surrounded by white matter edema

ClaireLewis at 22:35, 1 October 2019

2019-10-01T22:35:08Z

← Older revision		Revision as of 22:35, 1 October 2019
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	**Direct implantation by surgery or penetrating trauma (10%)		**Direct implantation by surgery or penetrating trauma (10%)
	*Microbiology		*Microbiology
	**Streptococci in 50% of cases<ref>Somand D, Meurer W. Central Nervous System Infections. EMCNA 2009; 27: 89-100.</ref>		**[[Streptococci]] in 50% of cases<ref>Somand D, Meurer W. Central Nervous System Infections. EMCNA 2009; 27: 89-100.</ref>
	**Anaerobes and Gram-negative rods are typical pathogens		**[[Anaerobes]] and [[Gram-negative]] rods are typical pathogens
	**Staph is involved with direct implantation cases		**[[Staph]] is involved with direct implantation cases

	==Clinical Features==		==Clinical Features==
	*Patients rarely appear acutely ill		*Patients rarely appear acutely ill
	*Classic ~~traid~~ of headache, fever, '''AND''' focal neuro deficit is present in <33%		*Classic triad of headache, fever, '''AND''' focal neuro deficit is present in <33%
	**Headache is most common symptom (present in almost all cases)		**[[Headache]] is most common symptom (present in almost all cases)
	**Fever (~50% of patients)		**[[Fever]] (~50% of patients)
	*Focal neuro symptoms or seizure (~33% of patients)		*[[Focal neuro]] symptoms or seizure (~33% of patients)
	*Neck stiffness (<50% of patients)		*Neck stiffness (<50% of patients)
	*Signs of increased ICP: papilledema, vomiting, confusion, obtundation (50% of patients)		*Signs of [[increased ICP]]: [[papilledema]], [[vomiting]], [[confusion]], [[coma\|obtundation]] (50% of patients)

	==Differential Diagnosis==		==Differential Diagnosis==
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	{{Intracranial mass DDX}}		{{Intracranial mass DDX}}
			{{AMS and fever DDX}}

	==Evaluation==		==Evaluation==
	~~===Workup===~~
	*[[Head CT]] with contrast		*[[Head CT]] with contrast
	*[[Blood cultures]]

	~~===Evaluation===~~
	*CT with contrast
	**Ring enhancing lesion surrounding low-density center surrounded by white matter edema		**Ring enhancing lesion surrounding low-density center surrounded by white matter edema
	**Early in course ring may be less defined; CT may only show area of focal hypodensity		**Early in course ring may be less defined; CT may only show area of focal hypodensity
			*[[Blood cultures]]
			*Consider additional workup to evaluate for alternate etiologies/complications of underlying disease process

	==Management==		==Management==

ClaireLewis: /* Differential Diagnosis */

2019-08-26T01:48:56Z

Differential Diagnosis

← Older revision		Revision as of 01:48, 26 August 2019
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[CVA]]		*[[CVA]]
	*[[Meningitis]]		*[[Meningitis]], [[encephalitis]]
	*Malignancy		*Malignancy

Adamhaag at 18:51, 19 August 2017

2017-08-19T18:51:30Z

← Older revision		Revision as of 18:51, 19 August 2017
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	**Direct implantation by surgery or penetrating trauma (10%)		**Direct implantation by surgery or penetrating trauma (10%)
	*Microbiology		*Microbiology
			**Streptococci in 50% of cases<ref>Somand D, Meurer W. Central Nervous System Infections. EMCNA 2009; 27: 89-100.</ref>
	**Anaerobes and Gram-negative rods are typical pathogens		**Anaerobes and Gram-negative rods are typical pathogens
	**Staph is involved with direct implantation cases		**Staph is involved with direct implantation cases
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	*Focal neuro symptoms or seizure (~33% of patients)		*Focal neuro symptoms or seizure (~33% of patients)
	*Neck stiffness (<50% of patients)		*Neck stiffness (<50% of patients)
	*Signs of increased ICP: vomiting, confusion, obtundation (50% of patients)		*Signs of increased ICP: papilledema, vomiting, confusion, obtundation (50% of patients)

	==Differential Diagnosis==		==Differential Diagnosis==

Mholtz: Text replacement - "==References== " to "==References== "

2017-07-24T01:13:21Z

Text replacement - "==References== " to "==References== <references/> "

← Older revision		Revision as of 01:13, 24 July 2017
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	==References==		==References==
			<references/>
	[[Category:Neurology]]		[[Category:Neurology]]
	[[Category:ID]]		[[Category:ID]]