خراج الدماغ في حالات القصور المناعي الشديد عندما لا يحقق العلاج الأولي الأهداف المتوقعة

References

DOI: 10.1016/j.cmi.2023.08.016

• We conditionally recommend a 3rd-generation cephalosporin and metronidazole combined with trimethoprim-sulfamethoxazole and voriconazole for empirical treatment of brain abscess in children and adults with severe immuno-compromise equivalent to organ transplant recipients, active chemotherapy or biological treatment, or haematological malignancies (Table 4) (conditional recommendation and very low certainty of evidence).
• Repeated neurosurgical aspiration, or in selected cases excision, should be carried out in case of clinical deterioration or enlargement of brain abscess, and is almost always required in those without any reduction in brain abscess volume by 4 weeks after first aspiration (good clinical practice statement).