Medicines for Brain abscess

What it is

A brain abscess is a collection of pus that builds up within the brain, usually as a result of an infection. It is rare but serious, and is a medical emergency that needs urgent treatment. A brain abscess can develop when an infection reaches the brain — for example spreading from an infection nearby (such as in the ear, sinuses, or teeth), from an infection elsewhere in the body carried in the bloodstream, or entering directly (for example after a head injury or surgery); people with a weakened immune system or certain heart conditions can be at higher risk. As the abscess forms and grows, it causes pressure and inflammation in the brain, leading to symptoms. These can include: a headache, which is often severe, persistent, and may be localised to one part of the head, and may not be relieved by ordinary painkillers; a high temperature; feeling or being sick; changes in mental state, such as confusion or irritability; drowsiness or reduced consciousness; seizures (fits); and symptoms reflecting the part of the brain affected, such as weakness on one side of the body, problems with speech or vision, or other neurological changes; a stiff neck may also occur. Because the symptoms can develop over days and can worsen, and because a brain abscess is serious, the combination of a severe or unusual headache with fever, and especially with neurological symptoms (such as confusion, drowsiness, seizures, weakness, or speech or vision problems), needs urgent medical assessment. A brain abscess is diagnosed with brain scans (such as CT or MRI) and other tests, and is treated in hospital, usually with a combination of antibiotics (or other medicines for the infection) and, often, a procedure or surgery to drain the pus and relieve the pressure. With prompt treatment, many people recover, though a brain abscess can be serious and some people are left with longer-term effects. The key message is to seek urgent help for a severe headache with fever and neurological symptoms.

How it is treated

A brain abscess is a medical emergency and is treated urgently in hospital, and prompt treatment improves the outcome. If a brain abscess is suspected — a severe, persistent, or unusual headache with a fever, and especially with neurological symptoms such as confusion, drowsiness, seizures, weakness, or problems with speech or vision — urgent medical assessment is essential. In hospital, the diagnosis is made with brain scans (CT or MRI, which show the abscess) and other tests to identify the infection and any source, such as blood tests, and sometimes a sample from the abscess. Treatment usually combines: medicines to treat the infection — antibiotics given into a vein (or antifungal or other medicines depending on the cause), often for a prolonged course; and, in many cases, a neurosurgical procedure to drain the pus from the abscess and relieve the pressure on the brain (for example draining it through a small hole, or surgery), which also allows the infection to be identified so treatment can be targeted. Treating the source of the infection (such as an ear, sinus, or dental infection) is also important. Supportive care in hospital manages symptoms and complications — for example controlling seizures, managing raised pressure in the brain, and supporting the person — and care may involve intensive treatment for severe cases. Recovery varies: with prompt treatment, many people recover, though a brain abscess is serious, and some people are left with longer-term effects (such as seizures or other neurological problems) and may need rehabilitation and follow-up. Because a brain abscess is serious and prompt treatment matters, the key message is recognition and urgency: a severe or unusual headache with fever, particularly with neurological symptoms, needs urgent assessment. It is worth noting that brain abscess is rare, and most headaches — even with a fever, as in common infections — are not a brain abscess; but the specific combination of a severe headache with fever and neurological symptoms is a warning sign that needs emergency assessment. The reassuring message is that, although a brain abscess is a serious emergency, prompt treatment with medicines and drainage of the pus, along with treating the source of infection, is often effective, and many people recover.