Brain abscess and hereditary hemorrhagic telangiectasia

Freitas, Leonardo Furtado; Duarte, Márcio Luí­s; Miranda, Eduardo Carvalho

doi:10.1590/0004-282x-anp-2021-0389

Cited by 1 publication

(1 citation statement)

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“…Since periodontitis is prevalent in approximately 50% of the adult population, this suggests that continuous exposure to impaired anatomical barriers in the oral cavity may contribute relatively more to risk of brain abscess compared with single higher-exposure events such as invasive dental procedures [24 ▪ ,25]. Several recent studies have focused on the high absolute and relative risk of developing brain abscess in patients with Hereditary Hemorrhagic Telangiectasia (HHT) and associated pulmonary arteriovenous malformations (PAVM) if left untreated [26,27 ▪ ,28]. A case-control study accessed a US-based national claims database and confirmed previous results of a significantly increased risk in adults with HHT [27 ▪ ].…”

Section: Developments In Epidemiologymentioning

confidence: 99%

Update and approach to patients with brain abscess

Omland,

Nielsen,

Bodilsen

2024

Current Opinion in Infectious Diseases

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Purpose of review The epidemiology of brain abscess has changed in recent decades. Moreover, acute and long-term management remains challenging with high risks of mortality and neurological sequelae. This review describes recent advances in epidemiology, diagnosis, and treatment of brain abscess. Recent findings The incidence of brain abscess is increasing, especially among elderly individuals. Important predisposing conditions include dental and ear-nose-throat infections, immuno-compromise, and previous neurosurgery. Molecular-based diagnostics have improved our understanding of the involved microorganisms and oral cavity bacteria including anaerobes are the predominant pathogens. The diagnosis relies upon a combination of magnetic resonance imaging, neurosurgical aspiration or excision, and careful microbiological examinations. Local source control by aspiration or excision of brain abscess combined with long-term antimicrobials are cornerstones of treatment. Long-term management remains important and should address neurological deficits including epilepsy, timely diagnosis and management of comorbidities, and potential affective disorders. Summary A multidisciplinary approach to acute and long-term management of brain abscess remains crucial and source control of brain abscess by neurosurgery should be pursued whenever possible. Numerous aspects regarding diagnosis and treatment need clarification. Nonetheless, our understanding of this complicated infection is rapidly evolving.

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Section: Developments In Epidemiologymentioning

confidence: 99%