Brain abscess

Differential diagnosis
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By John E Greenlee MD

Rapidly developing brain abscess may mimic bacterial or aseptic meningitis, epidural abscess, or subdural empyema (Kastenbauer et al 2004). The clinical presentation of temporal lobe abscesses may resemble that of herpes simplex virus encephalitis (Whitley et al 1986). More slowly developing abscesses may be mistaken for primary or metastatic tumors (Kastenbauer et al 2004; Tonon et al 2006; Brouwer et al 2014a; Brouwer et al 2014b). Brain abscesses presenting with abrupt change in patient condition may occasionally be mistaken for evolving cerebral or brainstem infarction, brain hemorrhage, subarachnoid hemorrhage, or, rarely, tumefactive multiple sclerosis (Altintas et al 2012). Diagnosis may be difficult in the patient who presents with an essentially encephalopathic picture, without fever, and without focal neurologic signs.

In This Article

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