Clinical Manifestations

Brain abscess is usually manifested by low-grade fever and symptoms of a space-occupying lesion. These include persistent localized headache, drowsiness, confusion, stupor, general or focal seizures, ataxia, nausea and vomiting, and focal motor or sensory impairments. Papilledema is present in the older child and adults, and bulging fontanels may be present in the younger infant. In the initial stages, the infection is in a form of encephalitis accompanied by signs of increased intracranial pressure such as papilledema. A ruptured brain abscess may produce purulent meningitis.

Localized neurologic signs are eventually found in most patients. The signs and/or symptoms are a direct function of the intracranial location of the abscess (Table 2).

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