Brain abscess - Revision history

Aidan: Text replacement - " species]]" to "]]"

2022-01-25T16:44:31Z

Text replacement - " species]]" to "]]"

← Older revision		Revision as of 16:44, 25 January 2022
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	*Direct spread (50%)		*Direct spread (50%)
	**'''Nose/sinuses:''' [[Streptococcus ~~species~~]] (especially [[Streptococcus anginosus group]]), [[Haemophilus ~~species~~]], [[Bacteroides ~~species~~]], [[Fusobacterium ~~species~~]]		**'''Nose/sinuses:''' [[Streptococcus]] (especially [[Streptococcus anginosus group]]), [[Haemophilus]], [[Bacteroides]], [[Fusobacterium]]
	**'''Teeth:''' [[Streptococcus ~~species~~]], [[Bacteroides ~~species~~]], [[Prevotella ~~species~~]], [[Fusobacterium ~~species~~]], [[Haemophilus ~~species~~]]		**'''Teeth:''' [[Streptococcus]], [[Bacteroides]], [[Prevotella]], [[Fusobacterium]], [[Haemophilus]]
	**'''Ears:''' [[Enterobacteriaceae]], [[Streptococcus ~~species~~]], [[Pseudomonas aeruginosa]], [[Bacteroides ~~species~~]]		**'''Ears:''' [[Enterobacteriaceae]], [[Streptococcus]], [[Pseudomonas aeruginosa]], [[Bacteroides]]
	*Hematogenous spread (25%)		*Hematogenous spread (25%)
	**'''Lungs:''' [[Streptococcus ~~species~~]], [[Fusobacterium ~~species~~]], [[Actinomyces ~~species~~]]		**'''Lungs:''' [[Streptococcus]], [[Fusobacterium]], [[Actinomyces]]
	**'''Urinary tract:''' [[Pseudomonas aeruginosa]], [[Enterobacter ~~species~~]]		**'''Urinary tract:''' [[Pseudomonas aeruginosa]], [[Enterobacter]]
	**'''Endocarditis:''' [[Viridans group streptococci]], [[Staphylococcus aureus]]		**'''Endocarditis:''' [[Viridans group streptococci]], [[Staphylococcus aureus]]
	**'''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus ~~species~~]]		**'''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus]]
	*Direct inoculation (10%)		*Direct inoculation (10%)
	**'''Penetrating head trauma:''' [[Staphylococcus aureus]], [[Enterobacter ~~species~~]], [[Clostridium ~~species~~]]		**'''Penetrating head trauma:''' [[Staphylococcus aureus]], [[Enterobacter]], [[Clostridium]]
	**'''Neurosurgery:''' [[Staphylococcus ~~species~~]], [[Streptococcus ~~species~~]], [[Pseudomonas aeruginosa]], [[Enterobacter ~~species~~]]		**'''Neurosurgery:''' [[Staphylococcus]], [[Streptococcus]], [[Pseudomonas aeruginosa]], [[Enterobacter]]
	*Cryptogenic (15%)		*Cryptogenic (15%)
	*Immunocompromised patient		*Immunocompromised patient
	**'''HIV:''' [[Toxoplasma gondii]], [[Nocardia ~~species~~]], [[non-tuberculous mycobacteria]], [[Listeria monocytogenes]], [[Cryptococcus neoformans]]		**'''HIV:''' [[Toxoplasma gondii]], [[Nocardia]], [[non-tuberculous mycobacteria]], [[Listeria monocytogenes]], [[Cryptococcus neoformans]]
	**'''Neutropenia:''' Gram-negative bacilli, [[Aspergillus ~~species~~]], [[mucormycosis]], [[Candida ~~species~~]], [[Scedosporium ~~species~~]]		**'''Neutropenia:''' Gram-negative bacilli, [[Aspergillus]], [[mucormycosis]], [[Candida]], [[Scedosporium]]
	**'''Transplantation:''' [[Aspergillus ~~species~~]], [[Candida ~~species~~]], [[mucormycosis]], [[Scedosporium ~~species~~]], [[Enterobacteriaceae]], [[Nocardia ~~species~~]], [[Toxoplasma gondii]], and [[Mycobacterium tuberculosis]]		**'''Transplantation:''' [[Aspergillus]], [[Candida]], [[mucormycosis]], [[Scedosporium]], [[Enterobacteriaceae]], [[Nocardia]], [[Toxoplasma gondii]], and [[Mycobacterium tuberculosis]]
	*Plus '''[[anaerobes]]''', which are common		*Plus '''[[anaerobes]]''', which are common
	*Other organisms: [[Nocardia ~~species~~]], [[Klebsiella pneumoniae]] (especially southeast Asia), [[Aspergillus]], [[Taenia solium]], and [[Toxoplasma gondii]]		*Other organisms: [[Nocardia]], [[Klebsiella pneumoniae]] (especially southeast Asia), [[Aspergillus]], [[Taenia solium]], and [[Toxoplasma gondii]]

	===Pathophysiology===		===Pathophysiology===

Aidan: /* Investigations */

2020-08-18T11:55:04Z

Investigations

← Older revision		Revision as of 11:55, 18 August 2020
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	**'''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus species]]		**'''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus species]]
	*Direct inoculation (10%)		*Direct inoculation (10%)
	** '''Penetrating head trauma:''' [[Staphylococcus aureus]], [[Enterobacter species]], [[Clostridium species]]		**'''Penetrating head trauma:''' [[Staphylococcus aureus]], [[Enterobacter species]], [[Clostridium species]]
	**'''Neurosurgery:''' [[Staphylococcus species]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Enterobacter species]]		**'''Neurosurgery:''' [[Staphylococcus species]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Enterobacter species]]
	*Cryptogenic (15%)		*Cryptogenic (15%)
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	*Microbiology (above) depends on mechanism of infection		*Microbiology (above) depends on mechanism of infection

	== Clinical Manifestations ==		==Clinical Manifestations==

	* Often non-specific		*Often non-specific
	* Headache is most common, then fever and focal neurological deficits		*Headache is most common, then fever and focal neurological deficits
	* May have seizures		*May have seizures
	* May have symptoms of increase ICP, such as comiting, blurry vision, drowiness, and confusion		*May have symptoms of increase ICP, such as comiting, blurry vision, drowiness, and confusion

	=== Prognosis and Complications ===		===Prognosis and Complications===

	* 10% mortality		*10% mortality
	* 50% seizures		*50% seizures
	* 20% significant cognitive impairment		*20% significant cognitive impairment

	==Investigations==		==Investigations==
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	*MRI with gadolinium		*MRI with gadolinium
	**Typically demonstrates a ring-enhancing lesion with thin rim		**Typically demonstrates a ring-enhancing lesion with thin rim
	**Temporal lobe or cerebellum suggests contiguous spread from chronic otitis or mastoiditis		**Temporal lobe and cerebellum suggests contiguous spread from chronic otitis or mastoiditis
	**Frontal lobe suggests contiguous spread from frontal or ethmoid sinusitis		**Frontal and temporal lobe suggests contiguous spread from frontal or ethmoid sinusitis
			**Frontal lobe and cerebellum can be secondary to meningitis
			**Frontal lobe scan be from dental infection or manipulation
	**Multiple abscesses in a middle cerebral artery distribution suggests bacteremia		**Multiple abscesses in a middle cerebral artery distribution suggests bacteremia
	*Blood cultures positive in 15%		*Blood cultures positive in 15%

Aidan: /* Microbiology */

2020-08-18T11:53:13Z

Microbiology

← Older revision		Revision as of 11:53, 18 August 2020
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	===Microbiology===		===Microbiology===

	*Direct spread		*Direct spread (50%)
	**'''Nose/sinuses:''' [[Streptococcus species]] (especially ''[[S. ~~milleri~~]]''), [[Haemophilus species]], [[Bacteroides species]], [[Fusobacterium species]]		**'''Nose/sinuses:''' [[Streptococcus species]] (especially [[Streptococcus anginosus group]]), [[Haemophilus species]], [[Bacteroides species]], [[Fusobacterium species]]
	**'''Teeth:''' [[Streptococcus species]], [[Bacteroides species]], [[Prevotella species]], [[Fusobacterium species]], [[Haemophilus species]]		**'''Teeth:''' [[Streptococcus species]], [[Bacteroides species]], [[Prevotella species]], [[Fusobacterium species]], [[Haemophilus species]]
	**'''Ears:''' [[Enterobacteriaceae]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Bacteroides species]]		**'''Ears:''' [[Enterobacteriaceae]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Bacteroides species]]
		⚫	*Hematogenous spread (25%)
⚫	**'''Penetrating head trauma:''' [[Staphylococcus aureus]], [[Enterobacter species]], [[Clostridium species]]
⚫	**'''Neurosurgery:''' [[Staphylococcus species]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Enterobacter species]]
⚫	*Hematogenous spread
	**'''Lungs:''' [[Streptococcus species]], [[Fusobacterium species]], [[Actinomyces species]]		**'''Lungs:''' [[Streptococcus species]], [[Fusobacterium species]], [[Actinomyces species]]
	**'''Urinary tract:''' [[Pseudomonas aeruginosa]], [[Enterobacter species]]		**'''Urinary tract:''' [[Pseudomonas aeruginosa]], [[Enterobacter species]]
	**'''Endocarditis:''' [[Viridans group streptococci]], [[Staphylococcus aureus]]		**'''Endocarditis:''' [[Viridans group streptococci]], [[Staphylococcus aureus]]
	**'''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus species]]		**'''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus species]]
			*Direct inoculation (10%)
		⚫	** '''Penetrating head trauma:''' [[Staphylococcus aureus]], [[Enterobacter species]], [[Clostridium species]]
		⚫	**'''Neurosurgery:''' [[Staphylococcus species]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Enterobacter species]]
			*Cryptogenic (15%)
	*Immunocompromised patient		*Immunocompromised patient
	**'''HIV:''' [[Toxoplasma gondii]], [[Nocardia species]], [[non-tuberculous mycobacteria]], [[Listeria monocytogenes]], [[Cryptococcus neoformans]]		**'''HIV:''' [[Toxoplasma gondii]], [[Nocardia species]], [[non-tuberculous mycobacteria]], [[Listeria monocytogenes]], [[Cryptococcus neoformans]]
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	**'''Transplantation:''' [[Aspergillus species]], [[Candida species]], [[mucormycosis]], [[Scedosporium species]], [[Enterobacteriaceae]], [[Nocardia species]], [[Toxoplasma gondii]], and [[Mycobacterium tuberculosis]]		**'''Transplantation:''' [[Aspergillus species]], [[Candida species]], [[mucormycosis]], [[Scedosporium species]], [[Enterobacteriaceae]], [[Nocardia species]], [[Toxoplasma gondii]], and [[Mycobacterium tuberculosis]]
	*Plus '''[[anaerobes]]''', which are common		*Plus '''[[anaerobes]]''', which are common
			*Other organisms: [[Nocardia species]], [[Klebsiella pneumoniae]] (especially southeast Asia), [[Aspergillus]], [[Taenia solium]], and [[Toxoplasma gondii]]

			===Pathophysiology===

		⚫	*Either from contiguous spread from a [[:Category:Head and neck infections\|head and neck infection]], hematogenous spread from [[bacteremia]] or [[endocarditis]], traumatic inoculation, or post-neurosurgery
			*Typically starts as a small focus of infection in the brain parenchyma, followed by cerebritis and eventual capsule formation to give an abscess
		⚫	*Microbiology (above) depends on mechanism of infection

			== Clinical Manifestations ==

			* Often non-specific
			* Headache is most common, then fever and focal neurological deficits
			* May have seizures
			* May have symptoms of increase ICP, such as comiting, blurry vision, drowiness, and confusion

	=== ~~Pathophysiology~~ ===		=== Prognosis and Complications ===

			* 10% mortality
⚫	* Either from contiguous spread from a [[:Category:Head and neck infections\|head and neck infection]], hematogenous spread from [[bacteremia]] or [[endocarditis]], traumatic inoculation, or post-neurosurgery
			* 50% seizures
⚫	* Microbiology (above) depends on mechanism of infection
			* 20% significant cognitive impairment

	==Investigations==		==Investigations==

			*MRI with gadolinium
	*MRI
			**Typically demonstrates a ring-enhancing lesion with thin rim
	**Temporal lobe or cerebellum suggests contiguous spread from chronic otitis or mastoiditis		**Temporal lobe or cerebellum suggests contiguous spread from chronic otitis or mastoiditis
	**Frontal lobe suggests contiguous spread from frontal or ethmoid sinusitis		**Frontal lobe suggests contiguous spread from frontal or ethmoid sinusitis
	**Multiple abscesses in a middle cerebral artery distribution suggests bacteremia		**Multiple abscesses in a middle cerebral artery distribution suggests bacteremia
			*Blood cultures positive in 15%
			*Lumbar puncture usually contraindicated due to mass effect and risk of herniation
			*Most important is aspiration of abscess for stain and culture, which is positive in 2/3 of cases
			**Can do bacterial or fungal ribosomal PCR if cultures negative

	==Management==		==Management==

	*Empiric therapy is directed at the likely organisms based on etiology (direct vs. hematogenous spread)		*Empiric therapy is directed at the likely organisms based on etiology (direct vs. hematogenous spread)
	*For likely oral, ear, or sinus source, treated with [[Is treated by::ceftriaxone]] and [[Is treated by::metronidazole]] at CNS doses		**For likely oral, ear, or sinus source, treated with [[Is treated by::ceftriaxone]] and [[Is treated by::metronidazole]] at CNS doses
	*For likely hematogenous spread, treated with [[Is treated by::vancomycin]]		**For likely hematogenous spread, treated with [[Is treated by::vancomycin]]
	*For uncertain etiology, combination of [[ceftriaxone]], [[metronidazole]], and [[vancomycin]]		**For uncertain etiology, combination of [[ceftriaxone]], [[metronidazole]], and [[vancomycin]]
	*For neurosurgical patients, [[Is treated by::vancomycin]] plus a broad-spectrum [[Antipseudomonal antibiotics\|antipseudomonal antibiotic]] such as [[Is treated by::ceftazidime]], [[Is treated by::cefepime]], or [[Is treated by::meropenem]]		**For neurosurgical patients, [[Is treated by::vancomycin]] plus a broad-spectrum [[Antipseudomonal antibiotics\|antipseudomonal antibiotic]] such as [[Is treated by::ceftazidime]], [[Is treated by::cefepime]], or [[Is treated by::meropenem]]
			*Source control with neurosurgical aspiration
			*Duration is typically 6 to 8 weeks of intravenous antibiotics following source control
			**Monitor with serial MRI, though abnormalities may persist after successful treatment
			*No role for routine use of steroids

	==Further Reading==		==Further Reading==

Aidan at 13:40, 13 August 2020

2020-08-13T13:40:31Z

@@ Line 1: / Line 1: @@
-== Background ==
+==Background==
 ===Microbiology===
@@ Line 20: / Line 20: @@
 *Plus '''[[anaerobes]]''', which are common
-== Investigations ==
+=== Pathophysiology ===
-== Management ==
+==Investigations==
 ==Further Reading==

Aidan at 13:38, 13 August 2020

2020-08-13T13:38:42Z

← Older revision		Revision as of 13:38, 13 August 2020
Line 1:		Line 1:
	== ~~Microbiology~~ ==		== Background ==

			===Microbiology===
⚫	* Direct spread
⚫	** '''Nose/sinuses:''' [[Streptococcus species]] (especially ''[[S. milleri]]''), [[Haemophilus species]], [[Bacteroides species]], [[Fusobacterium species]]
⚫	** '''Teeth:''' [[Streptococcus species]], [[Bacteroides species]], [[Prevotella species]], [[Fusobacterium species]], [[Haemophilus species]]
⚫	** '''Ears:''' [[Enterobacteriaceae]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Bacteroides species]]
⚫	** '''Penetrating head trauma:''' [[Staphylococcus aureus]], [[Enterobacter species]], [[Clostridium species]]
⚫	** '''Neurosurgery:''' [[Staphylococcus species]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Enterobacter species]]
⚫	* Hematogenous spread
⚫	** '''Lungs:''' [[Streptococcus species]], [[Fusobacterium species]], [[Actinomyces species]]
⚫	** '''Urinary tract:''' [[Pseudomonas aeruginosa]], [[Enterobacter species]]
⚫	** '''Endocarditis:''' [[Viridans group streptococci]], [[Staphylococcus aureus]]
⚫	** '''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus species]]
⚫	* Immunocompromised patient
⚫	** '''HIV:''' [[Toxoplasma gondii]], [[Nocardia species]], [[non-tuberculous mycobacteria]], [[Listeria monocytogenes]], [[Cryptococcus neoformans]]
⚫	** '''Neutropenia:''' Gram-negative bacilli, [[Aspergillus species]], [[mucormycosis]], [[Candida species]], [[Scedosporium species]]
⚫	** '''Transplantation:''' [[Aspergillus species]], [[Candida species]], [[mucormycosis]], [[Scedosporium species]], [[Enterobacteriaceae]], [[Nocardia species]], [[Toxoplasma gondii]], and [[Mycobacterium tuberculosis]]
⚫	* Plus '''[[anaerobes]]''', which are common

		⚫	*Direct spread
⚫	== Further Reading ==
		⚫	**'''Nose/sinuses:''' [[Streptococcus species]] (especially ''[[S. milleri]]''), [[Haemophilus species]], [[Bacteroides species]], [[Fusobacterium species]]
⚫	* Brain Abscesses. ''NEJM''. 2015;371:447-456. doi: [https://doi.org/10.1056/NEJMra1301635 10.1056/NEJMra1301635]
		⚫	**'''Teeth:''' [[Streptococcus species]], [[Bacteroides species]], [[Prevotella species]], [[Fusobacterium species]], [[Haemophilus species]]
		⚫	**'''Ears:''' [[Enterobacteriaceae]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Bacteroides species]]
		⚫	**'''Penetrating head trauma:''' [[Staphylococcus aureus]], [[Enterobacter species]], [[Clostridium species]]
		⚫	**'''Neurosurgery:''' [[Staphylococcus species]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Enterobacter species]]
		⚫	*Hematogenous spread
		⚫	**'''Lungs:''' [[Streptococcus species]], [[Fusobacterium species]], [[Actinomyces species]]
		⚫	**'''Urinary tract:''' [[Pseudomonas aeruginosa]], [[Enterobacter species]]
		⚫	**'''Endocarditis:''' [[Viridans group streptococci]], [[Staphylococcus aureus]]
		⚫	**'''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus species]]
		⚫	*Immunocompromised patient
		⚫	**'''HIV:''' [[Toxoplasma gondii]], [[Nocardia species]], [[non-tuberculous mycobacteria]], [[Listeria monocytogenes]], [[Cryptococcus neoformans]]
		⚫	**'''Neutropenia:''' Gram-negative bacilli, [[Aspergillus species]], [[mucormycosis]], [[Candida species]], [[Scedosporium species]]
		⚫	**'''Transplantation:''' [[Aspergillus species]], [[Candida species]], [[mucormycosis]], [[Scedosporium species]], [[Enterobacteriaceae]], [[Nocardia species]], [[Toxoplasma gondii]], and [[Mycobacterium tuberculosis]]
		⚫	*Plus '''[[anaerobes]]''', which are common

			== Investigations ==

			* MRI
			** Temporal lobe or cerebellum suggests contiguous spread from chronic otitis or mastoiditis
			** Frontal lobe suggests contiguous spread from frontal or ethmoid sinusitis
			** Multiple abscesses in a middle cerebral artery distribution suggests bacteremia

			== Management ==

			* Empiric therapy is directed at the likely organisms based on etiology (direct vs. hematogenous spread)
			* For likely oral, ear, or sinus source, treated with [[Is treated by::ceftriaxone]] and [[Is treated by::metronidazole]] at CNS doses
			* For likely hematogenous spread, treated with [[Is treated by::vancomycin]]
			* For uncertain etiology, combination of [[ceftriaxone]], [[metronidazole]], and [[vancomycin]]
			* For neurosurgical patients, [[Is treated by::vancomycin]] plus a broad-spectrum [[Antipseudomonal antibiotics\|antipseudomonal antibiotic]] such as [[Is treated by::ceftazidime]], [[Is treated by::cefepime]], or [[Is treated by::meropenem]]

		⚫	==Further Reading==

		⚫	*Brain Abscesses. ''NEJM''. 2015;371:447-456. doi: [https://doi.org/10.1056/NEJMra1301635 10.1056/NEJMra1301635]

	[[Category:CNS infections]]		[[Category:CNS infections]]

Aidan: /* Further Reading */

2020-08-13T13:28:46Z

Aidan: Text replacement - "Viridans group Streptococci" to "Viridans group streptococci"

2020-02-15T00:41:45Z

Text replacement - "Viridans group Streptococci" to "Viridans group streptococci"

← Older revision		Revision as of 00:41, 15 February 2020
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	** '''Lungs:''' [[Streptococcus species]], [[Fusobacterium species]], [[Actinomyces species]]		** '''Lungs:''' [[Streptococcus species]], [[Fusobacterium species]], [[Actinomyces species]]
	** '''Urinary tract:''' [[Pseudomonas aeruginosa]], [[Enterobacter species]]		** '''Urinary tract:''' [[Pseudomonas aeruginosa]], [[Enterobacter species]]
	** '''Endocarditis:''' [[Viridans group ~~Streptococci~~]], [[Staphylococcus aureus]]		** '''Endocarditis:''' [[Viridans group streptococci]], [[Staphylococcus aureus]]
	** '''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus species]]		** '''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus species]]
	* Immunocompromised patient		* Immunocompromised patient

Aidan: /* Microbiology */ added immunocompromised patients

2019-12-02T12:12:01Z

Microbiology: added immunocompromised patients

← Older revision		Revision as of 12:12, 2 December 2019
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	== Microbiology ==		== Microbiology ==

			* Direct spread
	* '''Nose/sinuses:''' ''[[Streptococcus]]'' spp (especially ''S. milleri''), ''[[Haemophilus]]'' spp, ''[[Bacteroides]]'' spp, ''[[Fusobacterium]]'' spp
	* '''~~Teeth~~:''' ''[[Streptococcus]]'' ~~spp,~~ ''[[~~Bacteroides~~]]'' ~~spp~~, ''[[~~Prevotella~~]]~~'' spp~~, ''[[~~Fusobacterium~~]]~~'' spp~~, ''[[~~Haemophilus~~]]~~'' spp~~		** '''Nose/sinuses:''' [[Streptococcus species]] (especially ''[[S. milleri]]''), [[Haemophilus species]], [[Bacteroides species]], [[Fusobacterium species]]
	* '''~~Ears~~:''' ''[[~~Enterobacteriaceae~~]]'', ''[[~~Streptococcus~~]]'' ~~spp~~, ''[[~~Pseudomonas~~ ~~aeruginosa~~]]'', ''[[~~Bacteroides~~]]~~'' spp~~		** '''Teeth:''' [[Streptococcus species]], [[Bacteroides species]], [[Prevotella species]], [[Fusobacterium species]], [[Haemophilus species]]
	* '''~~Lungs~~:''' ''[[Streptococcus]]~~'' spp~~, ''[[~~Fusobacterium~~]]~~'' spp~~, ''[[~~Actinomyces~~]]~~'' spp~~		** '''Ears:''' [[Enterobacteriaceae]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Bacteroides species]]
	* '''~~Urinary~~ ~~tract~~:''' ''[[~~Pseudomonas~~ ~~aeruginosa~~]]'', ''[[Enterobacter]]'' ~~spp~~		** '''Penetrating head trauma:''' [[Staphylococcus aureus]], [[Enterobacter species]], [[Clostridium species]]
	* '''~~Penetrating head trauma~~:''' ''[[Staphylococcus ~~aureus~~]]'', ''[[~~Enterobacter~~]]'' ~~spp~~, ''[[~~Clostridium~~]]~~'' spp~~		** '''Neurosurgery:''' [[Staphylococcus species]], [[Streptococcus species]], [[Pseudomonas aeruginosa]], [[Enterobacter species]]
			* Hematogenous spread
	* '''Neurosurgery:''' ''[[Staphylococcus]]'' spp, ''[[Streptococcus]]'' spp, ''[[Pseudomonas aeruginosa]]'', ''[[Enterobacter]]'' spp
			** '''Lungs:''' [[Streptococcus species]], [[Fusobacterium species]], [[Actinomyces species]]
⚫	* '''Endocarditis:''' [[Viridans ~~streptococci~~]], ~~''S.~~ aureus''
			** '''Urinary tract:''' [[Pseudomonas aeruginosa]], [[Enterobacter species]]
⚫	* '''Congenital cardiac malformations''' (especially right-to-left shunts): ''[[Streptococcus]]~~'' spp~~
		⚫	** '''Endocarditis:''' [[Viridans group Streptococci]], [[Staphylococcus aureus]]
		⚫	** '''Congenital cardiac malformations''' (especially right-to-left shunts): [[Streptococcus species]]
			* Immunocompromised patient
			** '''HIV:''' [[Toxoplasma gondii]], [[Nocardia species]], [[non-tuberculous mycobacteria]], [[Listeria monocytogenes]], [[Cryptococcus neoformans]]
			** '''Neutropenia:''' Gram-negative bacilli, [[Aspergillus species]], [[mucormycosis]], [[Candida species]], [[Scedosporium species]]
			** '''Transplantation:''' [[Aspergillus species]], [[Candida species]], [[mucormycosis]], [[Scedosporium species]], [[Enterobacteriaceae]], [[Nocardia species]], [[Toxoplasma gondii]], and [[Mycobacterium tuberculosis]]
	* Plus '''[[anaerobes]]''', which are common		* Plus '''[[anaerobes]]''', which are common

Aidan: added further reading

2019-12-02T12:03:36Z

added further reading

← Older revision		Revision as of 12:03, 2 December 2019
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	* '''Congenital cardiac malformations''' (especially right-to-left shunts): ''[[Streptococcus]]'' spp		* '''Congenital cardiac malformations''' (especially right-to-left shunts): ''[[Streptococcus]]'' spp
	* Plus '''[[anaerobes]]''', which are common		* Plus '''[[anaerobes]]''', which are common

			== Further Reading ==
			* Brain Abscesses. ''NEJM''. 2015;371:447-456. doi: [https://doi.org/10.1056/NEJMra1301635 10.1056/NEJMra1301635]]

	[[Category:CNS infections]]		[[Category:CNS infections]]

Aidan: Aidan moved page Brain abscesses to Brain abscess

2019-12-02T12:02:08Z

Aidan moved page Brain abscesses to Brain abscess

← Older revision		Revision as of 12:02, 2 December 2019
(No difference)

← Older revision		Revision as of 13:28, 13 August 2020
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	== Further Reading ==		== Further Reading ==
	* Brain Abscesses. ''NEJM''. 2015;371:447-456. doi: [https://doi.org/10.1056/NEJMra1301635 10.1056/NEJMra1301635]]		* Brain Abscesses. ''NEJM''. 2015;371:447-456. doi: [https://doi.org/10.1056/NEJMra1301635 10.1056/NEJMra1301635]

	[[Category:CNS infections]]		[[Category:CNS infections]]
			[[Category:Infectious diseases]]