Brain abscess
[Clin Microbiol Infect 2023;1-71]
- Surgical therapy usually required with either stereotactic aspiration or open drainage. Send fluid/tissue for Gram stain and culture.
- Rule out: sinusitis, otitis, dental infection, endocarditis, congenital heart disease, lung abscess.
- If multiple abscesses, blood cultures are recommended before antibiotics.
Usual Pathogens
Viridans Group Streptococci including Streptococcus anginosus group (S. anginosus, S. constellatus, S. intermedius)
Anaerobes
Enterobacterales
S. aureus/MRSA
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ceftriaxone | 100mg/kg/d IV div q12h | 6 weeks |
| + | ||
| Metronidazole | 30mg/kg/d IV div q8h | |
| +/- | ||
| Vancomycin | 60mg/kg/d IV div q6h |