- Suppurative infection involving the brain parenchyma
- May be a single or multiple lesions
- Males more commonly affected (2:1 male-to-female predominance).
- Typical age of presentation is 4–7 years but varies according to predisposing factor.
- 85% of cases have a predisposing risk factor.
∼1,500–2,500 cases (adults and pediatric combined) occur per year with up to 25% being children.
- Cyanotic congenital heart disease (tetralogy of Fallot is most common)
- Otorhinolaryngologic infections such as sinusitis, mastoiditis, and chronic otitis media
- Meningitis (especially in neonates)
- Penetrating head trauma
- Surgical manipulation of the brain (ventriculoperitoneal shunts, tumor removal)
- Congenital lesions of the head and neck
- Cystic fibrosis
- Dental infections
- Lung infections
- Patients who have traveled to endemic areas where neurocysticercosis (Latin America, parts of Africa, Asia, and the Indian subcontinent) is endemic
- Immunocompromised patients (congenital or acquired)
- During recreational activities, wearing helmets may prevent penetrating head trauma.
- Appropriate management of acute otitis media and acute sinusitis and timely recognition of treatment failure
- Microorganisms enter the brain parenchyma by contiguous or hematogenous extension.
- Location of brain abscesses:
- Cyanotic congenital heart disease patients tend to have abscesses within the middle meningeal artery distribution: frontal, parietal, and temporal lobes.
- Frontal abscesses are commonly seen with sinus and dental infections.
- Temporal, parietal, or cerebellar abscesses tend to occur with mastoiditis or otitis media.
- Brain abscesses can occur anywhere in the brain parenchyma, regardless of a predisposing risk factor, secondary to hematogenous metastasis.
- Bacteria are the most common causes.
- Streptococcus milleri group and Staphylococcus sp. are the most commonly cultured microorganisms.
- Neonates may develop brain abscesses as a complication of Gram-negative meningitis (Proteus, Citrobacter, Enterobacter, and Cronobacter species).
- Polymicrobial infections occur in 30–50% of cases.
- Anaerobic organisms are found with increasing incidence with improved laboratory and culture techniques. Common pathogens include Bacteroides, Peptostreptococcus, Fusobacterium, Propionibacterium, Actinomyces, Veillonella, and Prevotella.
- Neurocysticercosis is caused by the parasite, Taenia solium. Fungi and protozoa can cause brain abscess in immunocompromised patients.
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Cabana, Michael D., editor. "Brain Abscess." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14088/all/Brain_Abscess.
Brain Abscess. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14088/all/Brain_Abscess. Accessed May 28, 2023.
Brain Abscess. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14088/all/Brain_Abscess
Brain Abscess [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2023 May 28]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14088/all/Brain_Abscess.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Brain Abscess ID - 14088 ED - Cabana,Michael D, BT - Select 5-Minute Pediatrics Topics UR - https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14088/all/Brain_Abscess PB - Wolters Kluwer Health ET - 7 DB - Medicine Central DP - Unbound Medicine ER -