Effect of antibiotic therapy on proton MR spectroscopy findings in human pyogenic brain abscesses

Večeřa, Zdeněk; Krejčí, Tomáš; Krajča, Jan; Kanta, Martin; Lipina, Radim

doi:10.23736/s0390-5616.19.04699-x

Cited by 1 publication

(1 citation statement)

References 14 publications

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“…Diagnosis of cerebritis remains challenging but may present as poorly demarcated hyperintense lesions on FLAIR/T2-weighted images combined with absent to mild contrast enhancement on T1-weighted images [49]. Among other radiological modalities, a recent single-center prospective observational cohort study showed that MR spectroscopy was not helpful for differentiating brain abscess from tumor in patients already treated with antibiotics for >72 h [50].…”

Section: Imagingmentioning

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: Imagingmentioning

confidence: 99%