Brain Abscess

Focal, suppurative infection of the brain parenchyma, usually with a ring-enhancing appearance due to fibrous capsule; MC infective organisms include streptococci, staphylococci, and anerobes

• History / PE:
  HA, seizures, confusion, inattention, followed by increasing ICP and then focal neurological deficits (CN III, CN VI)
• Diagnosis:
  CT scan shows ring-enhancing lesion
  Increase ESR and CRP
  CSF analysis not necessary, may precipitate herniation syndrome
• Treatment:
  Borad spectrum ABx and surgical drainage
  Dexamethasone with taper in severe cases
  IV mannitol to decrease ICP