A brain abscess is a focal, suppurative process within the brain parenchyma; it begins in an area of devitalized brain tissue as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. One organism is cultured in the majority of abscesses (70%), two in 20%, and three or more in 10% of cases. Abscesses associated with mucosal infections (sinusitis) frequently have anaerobic bacteria. Clinical signs include non specific symptoms as fever, letharg during early stage. Later signs of raised intracranial pressure vomiting, severe headache, seizures and papilloedema develops. Focal neurological signs is seen subsequently. When the aetiological agent is not known the combination of a third-generation cephalosporin and metronidazole is used for 3-6 weeks. A large abscess should be drained surgically.
