Brain abscess complicating pregnancy

Abstract

Brain abscess is a potentially life-threatening complication that is only rarely associated with pregnancy. Although predispositions such as a preexisting infection, foreign body, or immunosuppression are often present, up to 30% of individuals could have no risk factors. Presenting symptoms are often nonspecific but suggestive of a central nervous system process and include headache, seizures, mental status changes, and focal neurologic deficits. Cranial imaging by computed tomography (CT) or magnetic resonance imaging (MRI) can suggest the diagnosis of abscess. Diagnosis is confirmed by aspiration of purulent material. Treatment involves antibiotics, often with surgical drainage. Vaginal delivery at term appears to be safe. Care of the affected gravida, including time and route of delivery, should be approached by a team representing perinatology, neurosurgery, infectious disease, and anesthesiology.