Brain Abscess

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Brain Abscess

• develops from acute suppurative encephalitis

• acts as space occupying lesion so do NOT do lumbar puncture

Routes

• direct spread

  • Gram -ve organisms

  • from paranasal sinuses or middle ear

• septic sinus thrombosis

  • mastoid cavity

  • middle ear via sigmoid sinus

• haematogenous spread

  • Infective Endocarditis

  • Bronchiectasis

  • often in parietal lobes

  • often multiple

• trauma / penetrating injury

Causative organisms

• Otogenic source (mixed growth)

  • Bacteroides fragilis (or other non-sporing anaerobes)

  • Eschericia coli, Proteus, Klebsiella (Gram negative aerobic)

  • Strep., Staph. (sometimes)

• Sinus source (pure growth)

  • Streptococcus milleri

  • Streptococcus pneumoniae

• Trauma (mixed growth)

  • Staphylococcus aureus

  • (other Gram-positive organisms)

  • Coagulase negative staphylococcus

  • propionobacteria

• Chest

  • Streptococcus milleri

  • Streptococcus pneumoniae

  • Staphylococci

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