- Usually associated with severe hypertension
- Usually occurs 3-6 months after initiation of immunosuppression
- Can present with seizures, HA, AMS, visual disturbances
- Typical imaging pattern in symmetrical white matter edema in the posterior cerebral hemispheres
Posted 07/27/16 11:07:52 AM by Adam Faye
Brain Abscesses: Common Bugs
- Bacteria - Strep (mouth/sinuses), Staph, Nocardia (look for lung nodule, weakly acid-fast), Actinomyces, Mycobacteria
- Fungal - Aspergillus (Lung/Sinus), Mucor
- Parasite - Toxoplasmosis
*If it were septic emboli to the brain - often localizes to grey-white matter junction
Posted 07/27/16 11:13:55 AM by Adam Faye
Patients with focal neuro signs from possible mass effect - CT Head before LP to minimize the possibility of herniation.
Posted 07/27/16 11:17:49 AM by Adam Faye
- For severe infection use 2-3 agents for empiric coverage: TMP-SMX/Carbepenem. usually 6-12 months of therapy needed.
- Linezolid can also be used but can lead to thrombocytopenia (usually 10 days after initiation of treatment).
- Sulfadiazine + Pyrimethamine
Posted 07/27/16 11:23:44 AM by Adam Faye
Ring Enhancing Lesions Differential:
- Brain Abscess
- CNS Lymphoma
- Infarct (Subacute phase)
- Demyelination lesion
- Radiation Necrosis
Posted 07/27/16 11:25:17 AM by Adam Faye
Created by Christopher Kelly
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