Brain abscess: A narrative review

Ruiz-Barrera, Miguel Ángel; Santamaría-Rodríguez, Andrés Felipe; Zorro, Óscar

doi:10.1016/j.neurop.2022.01.010

Cited by 11 publications

(23 citation statements)

References 56 publications

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Section: Resultsmentioning

confidence: 99%

“…To select the most appropriate drug, the pharmacokinetic and pharmacodynamic characteristics of each compound, previous treatment, administration routes, patient’s predisposing conditions, potential pathophysiological mechanism underlying the abscess, and the microorganism involved must be considered. [40]…”

Section: Resultsmentioning

confidence: 99%

“…Ruiz-Barrera et al include the presence of multiple brain abscesses with a diameter of < 1.5 cm, presence of a single lesion measuring < 1.5 cm diameter, lesion location in eloquent areas of the brain (ex.left temporal and frontal lobes for speech and language), and presence of concomitant infections (e.g., meningitis, ependymitis). [40]…”

Section: Resultsmentioning

confidence: 99%

“…In most cases, the management of brain abscesses combines surgery (drainage, excision, or stereotactic aspiration) and pharmacological treatment (oral, intravenous, or intrathecal antibiotics). [40] All patients diagnosed with brain abscesses should receive empirical antibiotic therapy, including treatment for aerobic and anaerobic pathogens.…”

Section: Treatmentmentioning

confidence: 99%

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Potential infection foci in the oral cavity and their impact on the formation of central nervous system abscesses: A literature review

Abed,

Paciorek,

Bursa

2023

Medicine

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Despite advancements in preventive, diagnostic, and therapeutic activities in medicine, inflammatory processes of the central nervous system remain a significant problem, posing a serious threat to life and health. Purulent central nervous system infections are unique, including abscesses of the brain and spine, which are severe infections occurring in 0.4% to 0.9% of 1000 patients worldwide. Central nervous system abscesses have varying etiology. For example, organized, encapsulated abscesses of the brain are a unique group of inflammatory processes in the central nervous system caused by inflammation around the teeth in 3% to 10% of cases. Sometimes, the condition of patients with brain abscesses is severe and life-threatening. Therefore, detecting and eliminating all causes early, including those potentially resulting from odontogenic infections, is important; accurate and early diagnosis enables appropriate treatment. This paper presents a review of the information available in the literature on brain abscesses and their relationship with odontogenic foci of infection in the oral cavity.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Potential infection foci in the oral cavity and their impact on the formation of central nervous system abscesses: A literature review

Abed,

Paciorek,

Bursa

2023

Medicine

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“…Hence supporting the diagnosis. (Brouwer et al, 2014)(Ruiz-Barrera et al, 2022 The abscess size is the most crucial aspect of treating this infection. Abscesses bigger than 2.5 cm are managed by combining medications and a surgical approach.…”

Section: Discussionmentioning

confidence: 99%

Multiple cerebral abscess caused by Klebsiella pneumonia on post tumor excision procedure

Rumbiak

Sugianto

Setyowatie

2022

ijhs

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A cerebral abscess can happen due to a nearby brain infection, other rare body parts spread, head injury and surgery procedures. Intracranial Klebsiella pneumoniae infection rarely happens and usually occurs in immunocompromised patients. We reported a case of a 50 years old immunocompetent woman with prior tumor excision that progressed to a cerebral abscess. The patient came to the ER unconscious with progressive right-side weakness, pus from previous operation scar, fever and headache since few days’ pre-admission. Laboratory findings were leukocyte 13.710, neutrophil 9%, CRP 7.6, and negative HIV test. The contrast CT scan resulted in a multiloculated ring enhancement left frontal lobe lesion sized 5.8x6.9x5.0 cm and perifocal oedema. Open craniotomy managed to evacuate ±40cc. The microbiology culture tested positive for Klebsiella pneumoniae. Despite proper technique and administration of prophylaxis antibiotics, severe infection that requires immediate intervention still develops in a small group of patients. Klebsiella pneumoniae is a common pathogen causing cerebral abscess in both immunocompromised and healthy patients. Pus drainage and immediate antibiotics administration improved all symptoms, including hemiparesis. This case highlights the importance of quick and right therapy.

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Spontaneous brain abscess formation: challenge of a shifting pathogen spectrum over the last 21 years – a single center experience

Kraus,

Overstijns,

Rahal

et al. 2024

Acta Neurochir

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Background Spontaneous intracerebral abscess formation is a rare condition presenting with a disabling sequela. The origin of infection can either be primary or secondary to an infection at another location. The site of primary infection - due to the proximity, often the oral cavity, the sinuses, and the orbit - determines the causative pathogens. Treatment often combines surgical and antimicrobial therapies. To determine the microbiology and respective changes and treatment outcome, we performed this retrospective monocentric cohort study of patients requiring surgical treatment of brain abscesses. Methods Patients undergoing surgical treatment of a primary intracranial abscess between January 2000 and January 2021 in the Department of Neurosurgery, Freiburg University Hospital were included. Demographic, clinical and imaging data were extracted from patients’ medical records and databases. Treatment approaches were also analyzed, and surgical therapy and antibiotic therapy were reported. Outcome was assessed by the modified Rankin score (mRS) and was dichotomized into good (mRS 0–3) and poor (mRS 4–6) outcome. Results We included 65 patients with spontaneous intracerebral abscess that were treated with neurosurgical intervention at our institution. Analysis of the causative pathogens showed an increasing dominance of rare pathogens such as fungi, parasites, mycobacteria and anaerobes. Outcome measured by the mRS was similar from 2005 to 2021. Conclusions The pathogen spectrum of spontaneous intracerebral abscess at our institution is shifting with rarer pathogens being increasingly detected. This retrospective analysis highlights the need for microbiological diagnosis and of combined surgical and antibiological treatment.

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Brain abscess: A narrative review

Cited by 11 publications

References 56 publications

Potential infection foci in the oral cavity and their impact on the formation of central nervous system abscesses: A literature review

Potential infection foci in the oral cavity and their impact on the formation of central nervous system abscesses: A literature review

Multiple cerebral abscess caused by Klebsiella pneumonia on post tumor excision procedure

Spontaneous brain abscess formation: challenge of a shifting pathogen spectrum over the last 21 years – a single center experience

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