Infection of the Central Nervous System - Brain Abscess (Suppurative Encephalitis)
Diagnosis: In any patient having one of the underlying causes, features suggestive of meningitis, raised intracranial tension or focal neurological deficit should suggest the possibility or brain abscess. Lumbar puncture should not be routinely done in such cases since the risk or coning is high. Moreover the CSF may not show diagnostic changes in the case of localized abscess.
The diagnosis can be confirmed by CT Scan which should be done of an early stage. X-ray skull may give evidence of sinusitis and rarely gas in the abscess cavity, if the abscess is caused by gas-producing organisms or the abscess is communicating with the paranasal sinuses.
Course and prognosis: If left untreated, brain abscess is fatal. Complications include rupture into cerebral ventricles producing ventriculitis, meningitis, rise in intracranial tension and secondary epilepsy. If the abscess is diagnosed early and treated, full recovery may occur. Mortality is higher in brain abscess complicating congenital heart disease. The overall mortality in large series is 11-15%.
The diagnosis can be confirmed by CT Scan which should be done of an early stage. X-ray skull may give evidence of sinusitis and rarely gas in the abscess cavity, if the abscess is caused by gas-producing organisms or the abscess is communicating with the paranasal sinuses.
Course and prognosis: If left untreated, brain abscess is fatal. Complications include rupture into cerebral ventricles producing ventriculitis, meningitis, rise in intracranial tension and secondary epilepsy. If the abscess is diagnosed early and treated, full recovery may occur. Mortality is higher in brain abscess complicating congenital heart disease. The overall mortality in large series is 11-15%.