Brain abscess, the path to diagnosis. Case report

Abstract

Brain abscess is a focal infection of the central nervous system (CNS), in which there are areas of localized cerebritis and central necrosis, surrounded by a well vascularized capsule. We present a 19-year-old case, with orobuccal and more recent cutaneous history, which starts with neurological symptoms. He is evaluated with laboratory tests and lumbar puncture without elucidating the etiology. Complementary neuroimaging tests were performed showing supratentorial lesions compatible with brain abscess. A sample was taken and the histopathological result determined infection by Staphylococcus Aureus. The patient was treated with antibiotic therapy, steroids and anticonvulsants with an immediate favorable evolution. He remains in controls. Brain abscess is a life-threatening disease that requires multidisciplinary management to achieve a timely diagnosis and management. Clinical manifestations are usually nonspecific, so the identification of the entity depends on neuroimaging studies and in case of infection, the diagnosis may require biopsy. Finally, treatment associates medical management with antibiotic therapy and neurosurgical intervention for drainage.