145.2 ð åèç
145.2.0.1 å¿ è â Brain Abscess Imaging
- MRI with contrast = gold
- Ring-enhancing lesion + restricted diffusion
- DDx ring lesion: abscess, glioma, mets, toxo (HIV), lymphoma
145.2.0.2 å¿ è â Empirical
- Ceftriaxone + Metronidazole + Vancomycin (community)
- Pseudomonas cover if otogenic
- HIV with multiple ring lesions â toxoplasmosis first-line: sulfadiazine + pyrimethamine + folinic acid
145.2.0.3 å¿ è â Spinal Epidural Abscess Triad
Back pain + Fever + Neuro deficit
- S. aureus #1
- Emergency surgical decompression if neuro deficit
- Vancomycin + 3rd gen ceph à 6 wks
145.2.0.4 å¿ è â DDx Ring-enhancing in HIV
| Diagnosis | Features |
|---|---|
| Toxoplasmosis | Multiple, basal ganglia + thalamus; CD4 < 100 |
| CNS lymphoma | Often single, periventricular; EBV PCR + in CSF |
| PML (no enhancement) | Demyelinating, no mass effect; JC virus |
| Tuberculoma | Single or multiple, in TB endemic |
| Bacterial abscess | DWI restricted diffusion |