A brain abscess is a discrete focus of infection within the brain.
What is going on in the body?
A brain abscess is a localized area of infection within the brain that in time is usually walled-off by the body creating a pocket of pus. This condition can result in brain swelling, brain damage involving the area of inflammation, and death if not treated in time.
What are the causes and risks of the infection?
A brain abscess not related to head trauma or brain surgery is generally caused by bacteria spreading from an infection elsewhere in the body. Occasionally, the cause is a fungal infection.
Infections that can spread to the brain include:
Individuals with an increase risk of brain abscess include persons with congenital heart defects, mechanical heart valves, who use illicit IV drugs or have weakened immune systems (i.e. HIV, poorly controlled diabetes mellitus, organ transplant patients, or anyone requiring immunosuppressive drugs).
What can be done to prevent the infection?
It is not possible to prevent a brain abscess, except by appropriate treatment of infections anywhere in the body.
How is the infection diagnosed?
Diagnosis is made by listening to the individual's history, performing a physical examination, and by obtaining a CT or MRI of the brain. It is very important to determine the source of infection, especially in someone with a weakened immune system.
Long Term Effects
What are the long-term effects of the infection?
The destruction and/or surgical removal of the abscess and the surrounding brain may cause permanent impairment related to the area of the brain involved. Weakness, visual loss, speech or language problems resulting from destruction of brain tissue may need to be treated with physical therapy, occupational therapy, or speech therapy.
Brain abscess is a serious disease and can cause death if not treated in time, that is, before coma has set in. However, otherwise healthy individuals with an abscess that is discovered and treated early enough may suffer no permanent deficits. A seizure disorder may develop following the infection and/or brain surgery.
What are the risks to others?
There are no risks to others from the brain abscess, but the underlying infection may be contagious to others.
What are the treatments for the infection?
Antibiotic medication will be given as treatment, and surgery may be required. The underlying cause of the brain abscess, if it can be determined, also needs to be treated to prevent recurrence of the brain abscess.
What are the side effects of the treatments?
Side effects of the antibiotics vary depending on the antibiotic used, ranging from none at all to, rarely, severe enough to cause death. Surgery on the brain can result in death, although more often it is life-saving. A seizure disorder may develop up to one year following the operation.
What happens after treatment for the infection?
Generally, the individual is followed routinely by his or her healthcare professional in a clinic setting after the infection has been successfully treated, to ensure early detection of any disease recurrence or complications from the medication or surgery.
How is the infection monitored?
During treatment with antibiotics, the abscess can be monitored with cranial CT scans or cranial MRIs. More importantly, the individual is monitored by physical examination in order to guide treatment and to determine the need for additional testing..
Merck Manual, Home Edition, CDC