A 40yr old male presented with altered mental status, seizures and vomiting. He has no h/o fever, neck stiffness. On CECT and MRI ring enhancing lesion at gray white interface is seen. General hygiene was poor and he has multiple dental caries. What is the next best step in management of this patient?
Most likely diagnosis is brain abscess as - There is absence of signs of meningeal irritation (fever, vomiting, neck stiffness) Is acquired by either contiguous spread from adjacent structure or hematogenous route Common sites of infection are - ear infections, paranasal sinuses & dental caries. CECT & MRI - reveal ring enhancing lesion at gray white interface. Rx - Appropriate antibiotic therapy To relive mass effect, aspiration/surgery can be done
Urgent parenteral antibiotics
Placement of ICP monitor
Lumbar puncture
Craniotomy
Cerebrovascular Diseases