Brain abscess.

A brain abscess is defined as a localized collection of pus within the parenchyma of the brain or meninges. Brain abscesses are a complication of ear, sinus, and/or dental infections. Although they may occur in many brain locations, the most common sites are frontal and temporal lobes. Modern neuroimaging and laboratory analysis have led to prompt diagnosis and have decreased the mortality rates from brain abscess. Critical care nurses have a vital role in performing accurate neurologic assessments, timely administration of antibiotics, and management of fever.

Central nervous system infections in the intensive care unit.

Infections of the central nervous system are a frequent cause for admission to the intensive care unit (ICU). These infections can be the reason for presentation to a hospital or a complication of an injury or surgical procedure. Diagnosing these infections can be very challenging, given the relative paucity of tests with high sensitivity and specificity. Regardless, identifying and treating the underlying cause remains the primary objective in each of these cases, but management of complications is the most common reason for ICU admission. Frequent complications include increased intracranial pressure, stroke, coma, and status epilepticus. Although the underlying infection often causes harm, the immune response to the agent and ensuing complications are often responsible for greater damage to the host. Even if the underlying infectious agent does not have a specific therapy, identifying it is important for limiting unnecessary testing. When certain infections are suspected, such as bacterial meningitis or viral encephalitis, empiric therapy should be initiated immediately. Outcomes for these conditions are linked to how quickly appropriate therapies are initiated.

'I've got tummy ache in my head'. Communicating with sick children.

The traumatic effects of illness and hospitalisation on the child can be minimised with appropriate and effective communication, both with and from the child. When verbal communication is not possible, alternative means of communicating must be set up as soon as feasible, to establish a two-way channel, thus reducing the likelihood of misconceptions, misunderstandings, and unnecessary fears and frustrations.

Multiple bilateral cerebral abscesses with hemorrhage.

Brain abscess with spontaneous hemorrhage is an uncommon illness. A rare case of multiple abscesses in both cerebral hemispheres complicated by hemorrhage is reported. Minimally invasive surgery utilizing magnetic resonance imaging (MRI) guidance was performed after extensive testing failed to yield a diagnosis. Streptococcus intermedius was isolated from cultures taken during surgery and intravenous antimicrobial therapy was instituted. Pathology other than metastatic neoplasms and subacute hemorrhage should be considered in cases of cerebral ring-enhancing masses with hemosiderin deposition.

Using a ventricular reservoir to instill amphotericin B.

Intrathecal administration of amphotericin B is the best method of eradicating intracranial fungal infections. The Ommaya reservoir provides an easy and practical method for fungicidal medication administration. Treatment of coccidioidomycosis with amphotericin B may be accomplished via an Ommaya reservoir. Astute nursing care is essential to prevent complications associated with this procedure.

Absceso cerebral en niños

Se revisaron las historias clínicas con diagnóstico comprobado de absceso cerebral en el Hospital de La Misericordia, entre el 1o de enero de 1980 y el 30 de septiembre de 1990 encontrandose 37 casos. Esta patología se presenta con mayor frecuencia en el grupo de los escolares y tiene una evolución subaguda. La sinusitis, la otomastoiditis y las cardiopatías congénitas cianosantes fueron las patologias más frecuentemente asociadas. Los abscesos frontales ocupan el primer lugar en presentación seguidos de los frontoparietales y parietales. La TAC fue el examen paraclinico de mayor sensibilidad y especificidad en 100 por ciento de los casos. Se considera que la localizacion del absceso y la patología asociada orientan hacia el germen etiologico y de esta forma a la antibioticoterapia más adecuada. Se dan pautas de tratamiento médico y quirurgico.

Brain abscess: an update.

Brain abscess has been a known complication of head trauma, dental and rhinogenic infections and congenital heart defects, but is rapidly becoming a new diagnosis in the ever-growing population of the immunocompromised patient. Organ transplantation has become commonplace. But, with the advent of more sophisticated agents to prevent organ rejection, comes the threat of brain abscess. In addition to the transplanted patient, the acquired immunodeficiency syndrome patient population is also at risk for development of brain abscess, making brain abscess an important diagnosis. A combination of surgical excision and antimicrobial therapy is usually indicated. Nursing care of these patients involves current knowledge of the antimicrobial agents used and their adverse effects, as well as availability of home health services and need for follow-up care.

Home antibiotic therapy for brain abscesses.

Patients with brain abscesses now have the option of receiving intravenous antibiotic therapy at home. However, before discharge from the hospital, these patients require significant education in aseptic technique, general catheter care, medication administration, and troubleshooting. Also provided is a review of the pathology, signs, symptoms, diagnosis, and treatment of adult brain abscesses.