The present prospective, descriptive study reports six cases of pyogenic brain abscess, treated at the Hospital II EsSalud Hospital in Cajamarca, Peru, from 1990 to 2006. The average age was 42 years, the minimum 9 years And 66% were older than 40 years; 3 cases of males and 3 of females. The primary foci were: bronchiectasis, chronic otitis media, dental abscess, chronic sinusitis, cardiogenic origin and in 1 case was not determined. The diseases or associated medical conditions were: malnutrition, HIV positive, diabetes mellitus and bacterial endocarditis; In 2 no background disease was determined and in 1 there was dental abscess curettage.
The onset symptoms are: headache in 50%, seizures 17%. The main symptom: convulsions in 66%, hemiparesis and alterations of the sensorium. The clinical picture was characterized by headache (83%), convulsions (66%), hemiparesis (66%), fever (66%), aphasia (50%), papilloedema and vomiting (50%) Meningeal and prefrontal signs (33%). Clinical syndromes: headache (83%), focal neurological (83%), focal (67%), febrile (67%), HEC (50%), meningeal (33% %).
CT scan and cerebral MRI revealed 6 cases of cerebral abscess, of right hemispheric location in 5 cases, 3 single and 3 multiple cases; 2 in the frontal lobe, 1 frontalparietal, 1 frontotemporal and 1 parietal. Two cases in cerebritis and 4 encapsulated phase, with surrounding edema and mass effect. The treatment was done with cefotaxime 1 gr c / 6 hs. VEV / 20 days, or ceftriazone 2 g c / 12 h VEV / 20 days, together metronidazole 500 mg c / 6hs. EV / 20 days. In 1 case the treatment was prolonged up to 60 days with oral metronidazole. The sequelae were: hemiparesis, prefrontal alterations, convulsions, metronidazole peripheral polyneuropathy. The clinical and tomographic evolution was favorable in 4 cases, 2 patients died.