[Primacy of medical treatment of cerebral abscesses (19 cases)].
Therapy in 19 consecutive cases of cerebral abscess was limited to medical treatment whenever possible, using high doses of a combination of several antibiotics. Long-term follow up by serial computed tomography was performed. Antibiotic treatment alone was effective in 8 patients with multiple hemispheric abscesses of metastatic origin, though one patient seen late with three large abscesses die on the 4th day. In 8 cases with single abscesses, medical treatment alone was effective: 5 had lesions less than 4 cm in diameter; in 2 cases with lesions 4 to 5 cm in diameter, additional abscess puncture was carried out. One patient required early excision of an occipital abscess, and 2 cases of pontocerebellar angle abscesses were also treated surgically. Antibiotic therapy alone was effective in 1 patient with a large brain stem abscess. Treatment of cerebral abscess has largely changed since the availability of computed tomography, with a progressively more important place being accorded to antibiotic therapy alone. The stage of the abscess does not appear to be a decisive factor in the choice of treatment, medical therapy appearing to provide a definitive cure with a minimum of sequelae in the majority of cases. Abscess puncture may be an adjunct to antibiotic therapy in large abscesses with clinical signs.
D000293:Adolescent; D000328:Adult; D000617:Aminoglycosides / Q000008:administration & dosage*; D000667:Ampicillin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014295:Trimethoprim / Q000008:administration & dosage*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000667:Ampicillin; D014295:Trimethoprim
Primauté du traitement médical des abcès cérébraux (19 cas).