eMedicine Specialties > Infectious Diseases > CNS Infections

Brain Abscess: Follow-up

Author: Itzhak Brook, MD, MSc, Professor, Department of Pediatrics, Georgetown University School of Medicine
Contributor Information and Disclosures

Updated: Jun 26, 2008

Follow-up

Further Inpatient Care

  • Most abscesses are managed with intravenous antibiotic therapy to enable the organization of the lesion and to reduce local extension of the infection. After that period, definitive treatment consists of aspiration, incision and drainage, or excision.
  • Currently, nonoperative approaches (ie, prolonged courses of parenteral antibiotics) are rarely used. An exception is an abscess at an inoperable site. Such cases are uncommon, as many abscesses that were once inoperable can now be reached by stereotactic aspiration guided by precision mapping of the lesion's location with CT or MRI. Magnetic resonance fluoroscopy is used to guide aspiration instead of stereotactic aspiration.

Prognosis

  • A poorer prognosis is associated with a delayed diagnosis or a misdiagnosis, multiple and deep abscesses, ventricular rupture, coma, inadequate treatment, and specific organisms (ie, Aspergillus species, other fungi, Pseudomonas species).

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to diagnose or properly treat a brain abscess can lead to medical liability.

Special Concerns

  • The development of a brain abscess can be slow and subtle in some patients, especially those who are immunocompromised or on steroids.
 


More on Brain Abscess

Overview: Brain Abscess
Differential Diagnoses & Workup: Brain Abscess
Treatment & Medication: Brain Abscess
Follow-up: Brain Abscess
Multimedia: Brain Abscess
References
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Further Reading

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Keywords

brain abscess, abscess of the brain, brain disease, intra-cranial abscess, intracranial abscess, subdural empyema, extradural empyema, intracranial inflammation, intra-cranial inflammation, Staphylococcus aureus, S aureus, Streptococcus intermedius, S intermedius, Bacteroides, Prevotella, Pseudomonas, pseudomonal organisms, streptococci, anaerobic bacilli, anaerobic infection, Enterobacteriaceae

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Contributor Information and Disclosures

Author

Itzhak Brook, MD, MSc, Professor, Department of Pediatrics, Georgetown University School of Medicine
Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, Armed Forces Infectious Diseases Society, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Ear, Nose and Throat Advances in Children, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, and Surgical Infection Society
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey D Band, MD, Clinical Professor of Medicine, Wayne State University School of Medicine; Director, Division of Infectious Diseases and International Medicine, William Beaumont Hospital Corporation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Ronald A Greenfield, MD, Professor, Department of Internal Medicine, Section of Infectious Diseases, University of Oklahoma College of Medicine
Ronald A Greenfield, MD is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Central Society for Clinical Research, Infectious Diseases Society of America, Medical Mycology Society of the Americas, Phi Beta Kappa, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology
Disclosure: Pfizer Honoraria Speaking and teaching; Gilead Honoraria Speaking and teaching; Ortho McNeil Honoraria Speaking and teaching; Wyeth Honoraria Speaking and teaching; Abbott Honoraria Speaking and teaching; Astellas Honoraria Speaking and teaching; Cubicin  Speaking and teaching

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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