This patient had been treated over the preceding weeks for a left-sided parapharyngeal abscess, before presenting with altered mentation. They went on to have a craniotomy and evacuation of the cerebral abscess.
Microbiology
Specimen Type: Pus
Description: Left Frontal Cerebral Abscess
GRAM STAIN
- Leukocytes: +++
- Gram-positive bacilli: +++
- Gram-negative coccobacilli: +++
- Gram-negative bacilli: +
CULTURE
- Prevotella Sp: +++
- Propionibacterium acnes: +++
Discussion
Historically direct extension from adjacent infections was the most common source of cerebral abscesses. More recently hematological spread has become the most common etiology.