Brain abscess: A narrative review

Background: Brain abscess is a severe focal infection of the central nervous system (CNS) with an annual incidence of up to 8% in developing countries. This article aims to present a comprehensive review of the literature on the pathophysiology, clinical presentation, diagnosis, and treatment of brain abscess. Methods: We conducted a narrative review of the literature employing the PubMed, Embase, and Google Scholar databases. The terms “brain abscess,” “physiopathology,” “clinical presentation,” and “treatment” were combined using the Boolean operator AND (eg, “brain abscess” AND “physiopathology” or “brain abscess” AND “clinical presentation”). We analysed the titles and abstracts of all articles in English and Spanish, applying no restrictions regarding their publication date, selecting 69 articles for full-text review. Conclusions: Brain abscess is a frequent infectious disease of the CNS whose prevalence is higher in developing countries. The main pathophysiological mechanisms are related to bacterial spread from adjacent or distal foci. Laboratory findings can be nonspecific. Therefore, neuroimaging and microbiology tests play a fundamental role in establishing the most appropriate treatment for each patient.