Cerebral abscess is the classic intracerebral space occupying lesion with fever known since Hippocratic times. It is still a diagnostic challenge in these days of more rapid diagnosis due to ease of access to CT scanners. The urgent management challenges still tax the neurosurgeon and microbiologist. Immunosuppression can predispose patients to the development of brain abscesses, often with exotic organisms. Tuberculosis still causes cerebral abcesses. Thus a wide range of bacteria and fungi or protozoa could be responsible. Cryptogenic infection still is found in over 15% but common causes include:
- Septicaemia or bactraemia
- Otogenic or mastoiditis, sometimes by direct extension from middle ear infection or sometimes by indirect spread
- Odontogenic abscesses
- Cardiogenic due to endocarditis or shunts
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