Brain abscess

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By John E Greenlee MD

Brain abscess occurs worldwide with an incidence of approximately 4 per million population and accounts for approximately 1 in 10,000 hospitalizations (Kastenbauer et al 2004). In most series, males are affected more frequently than females (Chun et al 1986; Kastenbauer et al 2004; Brouwer et al 2014a; Brouwer et al 2014b). Brain abscess is most common in the third decade of life but may occur at any age (Roche et al 2003; Kastenbauer et al 2004). Abscesses due to paranasal infections are most common between the ages of 10 and 30 years. Otogenic abscesses are most common in childhood and after 40 years of age. Brain abscess in children is uncommon and has a peak incidence between 4 and 7 years of age (Shachor-Meyouhas et al 2010). Predisposing factors, in particular sinusitis, otitis, mastoiditis, head trauma, or meningitis, are present in up to 81% of affected children (Shachor-Meyouhas et al 2010). In the past, roughly 25% of children with brain abscess had cyanotic congenital heart disease. At present, however, this association is unusual (Ersahin et al 1994; Shachor-Meyouhas et al 2010).

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited