Once a relatively common disease with a dreadful outcome, brain abscess is less common now than it was at one time because of more efficacious treatments of sinusitis and middle ear infection. Abscess is also less deadly thanks to advanced diagnostic techniques and antibiotic regimens. New disease pathogens, however, have renewed concern about the diagnosis and treatment of brain abscess.
Abscess usually begins as cerebritis, eventually becoming necrotic and subsequently encapsulated.
Morbidity in survivors generally is due to residual focal defects, increased incidence of seizures due to scar tissue foci, or neuropsychiatric changes. To date, no differences in incidence of brain abscess by race have been apparent. Men develop brain abscesses twice as often as women. Classically, patients present to the ED with headache, low-grade fever, and a focal neurological defect or seizure. Patients may complain of nausea, vomiting, or stiff neck.