Brain abscess in immunocompetent adult patients
In: Revue Neurologique, Jg. 175 (2019-09-01), S. 469-474
Online
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Zugriff:
Brain abscess is a focal infection of the brain due to contiguous spread of pathogens following otitis, sinusitis, neurosurgery or traumatic brain injury or through hematogenous dissemination. Classical symptoms consisting of headache, fever, and focal signs may be absent on admission and brain MRI with contrast plays a major role in diagnosis. Initial management consists of stereotactic aspiration for microbiological documentation empirical treatment covering common pathogens, including oral streptococci, staphylococci, anaerobes, and Enterobacteriaceae. De-escalation of antimicrobials based on microbiology is safe only when samples have been processed optimally, or when primary diagnosis is endocarditis. A 6-week combination of third-generation cephalosporin and metronidazole will cure most cases of community-acquired brain abscess in immunocompetent adults. Significant advent in brain imaging, minimally invasive surgery, molecular biology, and antibacterial agents, has dramatically improved the prognosis. Main indicators of outcome include altered mental status at presentation and intraventricular rupture.
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Brain abscess in immunocompetent adult patients
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Autor/in / Beteiligte Person: | Sonneville, Romain ; Tattevin, Pierre ; Cantiera, M. ; Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord ; Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes] ; CHU Pontchaillou [Rennes] |
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Zeitschrift: | Revue Neurologique, Jg. 175 (2019-09-01), S. 469-474 |
Veröffentlichung: | Elsevier BV, 2019 |
Medientyp: | unknown |
ISSN: | 0035-3787 (print) |
DOI: | 10.1016/j.neurol.2019.07.002 |
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