Surgical drainage is a necessary part of the management of abscesses. Antibiotic treatment for 28 days or longer may be required for conditions such as liver abscess. The choice of antibiotics will be influenced by the presence, or possible presence, of gram-negative anaerobes in the infection. These organisms may be isolated in pure culture or mixed with anaerobes . On rare occasions, Strep.
Brain abscess is a focal suppuration within the brain parenchyma.
Brain abscesses occur more commonly in males , with a median age of 30 to 45 years. This is followed in frequency by frontoparietal, parietal, cerebellar and occipital involvement. It is postulated that brain abscess may develop from a contiguous site either by direct extension through adjacent osteitis or osteomyelitis or via retrograde thrombophlebitis of the diploic or emissary veins. In otogenic infections, spread may also occur through existing channels such as the internal auditory canal or the vestibular or cochlear aqueducts. However, these proposed mechanisms do not entirely explain the pathogenesis of brain abscess, including the mechanism by which organisms cross an intact dura.