Brain abscess (collection of pus)

Head | Neurology | Brain abscess (collection of pus) (Disease)


Brain abscesses can develop from an ear infection, dental abscess, infection of paranasal sinuses, infection of the mastoid air cells of the temporal bone, epidural abscess. If the skull is penetrated, bacteria may enter the brain and cause infection. The most common source is a lung infection.

The most frequent presenting symptoms are headache, drowsiness, confusion, inattention, irritability, fever and chills, vomiting, stiff neck, seizures, hemiparesis, loss of muscle function and language difficulties.

Left untreated, complications can appear. These are: brain damage; meningitis that is severe and life threatening and return (recurrence) of infection.

Causes and Risk factors

Brain abscess is usually associated with congenital heart disease in young children. The following raise the risk of a brain abscess: a weakened immune system such as in AIDS patients; chronic disease such as cancer or Osler-Weber-Rendu syndrome; drugs that suppress the immune system like corticosteroids or chemotherapy; right-to-left heart shunts, usually the result of congenital heart disease.

Diagnosis and Treatment

Tests to diagnose a brain abscess may include: head CT scan, Electroencephalogram (EEG); blood cultures, complete blood count (CBC); MRI of head. Testing for the presence of antibodies to organisms such as Toxoplasma gondii and Taenia solium may be performed and also needle biopsy to identify the cause of the infection.

The treatment includes lowering the increased intracranial pressure and starting intravenous antibiotics. Antifungal medications may also be prescribed if the infection is likely caused by a fungus. Surgery is needed if the pressure in the brain continues or gets worse and the brain abscess does not get smaller after medication. ...