Brain abscess is a collection of pus, surrounded by a capsule, located in the brain tissue. It arises due to infections by bacteria, fungi, mycobacteria or parasites, and can cause symptoms such as headache, fever, vomiting and neurological changes, such as loss of strength or seizures, depending on its size and location.
Generally, a brain abscess appears as a serious complication of an infection that already exists in the body, such as otitis, deep sinusitis or dental infection, for example, either by the spread of the infection or by dissemination through the blood, but it also happens as a result of a contamination from brain surgery or head trauma.
Treatment involves medications that combat the causative microorganism, such as antibiotics or antifungals, and in many cases it is also necessary to perform surgical drainage of the accumulated pus, favoring healing and faster recovery.
Main symptoms
The symptoms of brain abscess vary according to the causing microorganism, the person’s immunity, as well as the location and size of the lesion. Some of the main symptoms include:
- Headache;
- Nausea and vomiting;
- Seizures;
- Localized neurological changes, such as changes in vision, speech difficulties or loss of strength or sensitivity in parts of the body, for example;
- Stiff neck.
Furthermore, if it causes brain swelling or is very large, the abscess can also cause signs and symptoms of intracranial hypertension, such as sudden vomiting and changes in consciousness. Understand better what intracranial hypertension is and what causes it.
How to confirm the diagnosis
The diagnosis of brain abscess is made by the doctor, based on clinical evaluation, physical examination and request for tests such as computed tomography or magnetic resonance imaging, which demonstrate changes typical of the disease stages, such as brain inflammation, areas of necrosis and collection of pus. surrounded by a capsule.
Blood tests such as blood counts, inflammation markers, and blood cultures can help identify the infection and the causative agent.
Risk factors and causes
Generally, a brain abscess is caused by an infection that already exists in the body, and people who are more likely to develop this complication include:
- People with compromised immunity, such as people with AIDS, transplant recipients, those using immunosuppressive medications or those who are malnourished, for example;
- Injectable illicit drug users,
- Patients with respiratory infections such as sinusitis, otitis, mastoiditis or pneumonia;
- People with acute endocarditis;
- Patients with dental infections;
- Diabetics;
- People who have had lung infections such as empyema or lung abscesses. Find out how a lung abscess forms and what to do;
- Victims of head trauma or who have undergone cranial surgery, due to the direct introduction of bacteria into the region.
Some of the microorganisms that usually cause brain abscess are bacteria such as staphylococci or streptococci, fungi such as Aspergillus or Candidaparasites, such as Toxoplasma gondiiwhich causes toxoplasmosis, or even mycobacteria Mycobacterium tuberculosiswhich causes tuberculosis.
How the treatment is carried out
Brain abscess treatment involves the use of powerful antimicrobials, such as antibiotics or antifungals, administered intravenously, to combat the causing microorganism. In addition, drainage of the abscess in a surgical center by a neurosurgeon is usually recommended.
It is still necessary to remain hospitalized for a few more days to observe clinical improvement and monitor exams.
Bibliography
- UPTODATE. Pathogenesis, clinical manifestations, and diagnosis of brain abscess. 2021. Disponível em: <https://www.uptodate.com/contents/pathogenesis-clinical-manifestations-and-diagnosis-of-brain-abscess?search=abscesso%20cerebral&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2>. Acesso em 06 mar 2022
