Brain Abscess

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KEY POINTS

• A brain abscess is a pocket of pus that forms in the brain usually from an infection.
• You may need treatment with medicine and possibly surgery, and you may need to stay in the hospital.
• Ask your healthcare provider how long it will take to recover, when you can return to your normal activities, and how to take care of yourself at home.

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What is a brain abscess?

A brain abscess is often caused by an infection of the brain. Your body forms a pocket of pus surrounding the infection called an abscess. Pus is a thick fluid that usually contains white blood cells, dead tissue, and germs.

What is the cause?

You can get an infection of the brain from bacteria or fungus. The infection can get to your brain by moving from another part of your body through the blood. The source may be an infection that starts in your sinuses, ears, mouth, lungs, heart, or other places. You can also get an infection after surgery on your brain or from another kind of wound in the brain such as from trauma such as a bullet or some other head injury.

The infection makes cells in the brain die. The infected area of the brain may have inflammation (swelling and redness) and may form pus. Your body protects the rest of the brain from the infection and the pus by forming a wall around the area, which is the abscess.

Abscesses are more common and may be harder to treat in people who have diabetes or poor circulation, and in people whose immune systems are weakened by HIV or AIDS, cancer, or other serious health problems.

What are the symptoms?

Symptoms of a brain abscess may come on slowly, or they may start quickly. A brain abscess may cause pressure to build-up inside your head (skull). This pressure can be from swelling or a buildup of blood and fluids in the part of your brain where the abscess is. Symptoms can depend on where the abscess is in your brain. Different parts of the brain control different parts of the body, which are then affected. Symptoms of a brain abscess may include:

• Headache that persists or does not get better with usual nonprescription pain medicine
• Stiff neck
• Tiredness
• Nausea and vomiting
• Problems with vision, hearing, smell, taste, or touch
• Trouble thinking or speaking clearly
• Weakness or trouble moving a part of your body
• Dizziness or loss of balance
• Fever and chills
• Seizures
• Coma

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have tests such as:

• A neurological exam, which is testing to check your strength, sensation, balance, reflexes, thinking, and memory
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the brain
• CT, which uses X-rays and a computer to show detailed pictures of the brain

You may have tests to find out what kind of germ is causing the infection. These tests may include:

• Blood tests that may include blood cultures. The blood is sent to the lab and tested for many things including growth of bacteria or other germs. It may take several days to find out what kind of germ is causing the infection. Knowing what germ is causing the infection helps your provider choose the right medicine to treat it.
• Urine tests
• Sputum culture, which is a test of a sample of mucus coughed up from deep in your lungs
• Biopsy of the brain, which is the removal of a small sample of brain tissue for testing from the abscess area. When you have a biopsy, you will be given an anesthesia medicine first so that you will not feel any pain.
• Lumbar puncture, also called a spinal tap, which uses a needle to get a sample of fluid from the area around the spinal cord

How is it treated?

The treatment of a brain abscess depends on the place and type of infection you have. Treatment must start right away, and you will usually stay in the hospital. You may be in the intensive care unit depending on your symptoms.

• You may be given IV fluids and antibiotics or other medicine to treat the infection. Antibiotics treat infections either by killing bacteria or by stopping their growth. You may need more than one type of antibiotic medicine for some infections. If the infection is caused by a fungus, you will need antifungal medicine.
• You may be given other medicines to:
  • Treat pain
  • Prevent or treat seizures
  • Prevent or treat nausea and vomiting
  • Reduce fluid build-up in the brain and other tissues
  • Help you rest
  • Control blood pressure
• You may need surgery to drain the abscess and reduce the pressure on your brain

How can I take care of myself?

• Follow the full course of treatment prescribed by your healthcare provider.
• Ask your healthcare provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent a brain abscess?

You can help prevent a brain abscess by taking good care of your health. See your healthcare provider right away if you have symptoms of an infection.

If you have an infection, take your medicine for as long as your healthcare provider prescribes, even if you feel better. If you stop taking the medicine too soon, you may not kill all of the germs and you may get sick again. If you have side effects from your medicine, talk to your healthcare provider.