Brain Abscess

Clinical Description

Collection of pus in the brain parenchyma

Causes:

• Infection: Streptococcus Pneumoniae. Staphylococcus aureus, Haemophilus

Influenza B

• Complication of meningitis, Mastoiditis, and sinusitis
• Pott’s puffy tumor
• Cardiac
• Cyanotic congenital heart disease
• Infective endocarditis

Signs and Symptoms

• Persistent fevers
• Seizures
• Focal neurological signs
• Altered level of consciousness

Investigations

• FBC
• Blood culture
• Urgent CT brain

Pharmacological

Adults

• Ceftriaxone, IV, 2 g 12 hourly Plus
• Metronidazole, oral, 400 mg 8 hourly or IV, 500 mg 8 hourly. Adjust according to antimicrobial sensitivity after surgical drainage.

Children

• Ceftriaxone 100mg/kg IV q24h
• Metronidazole 7.5mg/kg IV 8 hourly. Adjust according to antimicrobial sensitivity after surgical drainage.
• Adequate analgesia
• Treat seizures

Non-pharmacological

• Urgent referral to tertiary facility for imaging and neurosurgical intervention
• Neuro protective measures

Complications

• Raised intracranial pressure
• Seizures
• Syndrome of Inappropriate ADH Secretion
• Stroke

Complications and Referral Criteria

All patients with suspected brain abscess for imaging and neurosurgical intervention

• All post-op patients for Intensive Medical rehabilitation Services.