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8 Cards in this Set
- Front
- Back
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Bacterial abscess clinical features
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-focal deficits
-altered thinking (depending on area involved) -HA -n/v -fever -progresses over weeks |
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Bacterial abscess course
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Days 1-3: focal cerebritis (PMNs, edema)
Days 4-9: late cerebritis (necrosis, pus) Days 10-13: early encapsulation (scattered fibroblast prolif, reactive astrocytosis, capillaries) Days 14+: late encapsulation abscess with 5 layers 1.necrotic center 2.granulation tissue with fibroblasts and capillaries 3.lymphocytes and plasma cells 4.dense fibrous tissue with astrocytes 5.gliosis and edema |
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Bacterial abscess Dx
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-Cerebritis stage: non-enhancing low signal on CT and MRI
-Abscess stage: ring enhancing mass with surrounding edema on CT and MRI (ring esp. sharp with contrast) |
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Bacterial abscess organisms
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-Strep
-Staph -Enterobacter -anaerobes (req. metronidazole for Tx) |
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Bacterial abscess Tx
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-resection v. aspiration
-Ab tailored to cultured organism -empiric Abs: 3rd gen cephalosporin or penicillin + metronidazole |
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Non-bacterial abscess
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-Distinguish by microscopy
-Fungi: Apergillus (hematogenous from lungs or direct from sinuses in head trauma), crypto (dense fibrosis, mn giant cells) -Parasites: Toxoplasma (acquired by consumption of undercooked meat or cat feces, aSx in immunocompetent, re-activation Sx in immunocompromised, free parasites = tachyzoites, parasites within pseudocysts = bradyzoites) |
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Bacterial Abscess CSF
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WBCs elevated
Protein elevated Opening pressure elevated Glucose NORMAL |
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Abscess rupture complications
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-ventriculitis
-meningitis -venous sinus thrombosis (all have high mortality rate without antibiotics and/or surgery) |
