Brain Infection (cont.)
Brain Infection Treatment
Antibiotics given through a vein, as well as medications for fever and headache, are used in the treatment of brain infections.
Anyone in respiratory distress will receive oxygen and be closely observed.
IV fluids and electrolyte replacement are given to those with continuing nausea and vomiting.
Anticonvulsants are used to prevent or treat seizures.
Irritable or restless people will receive mild sedation.
If there is evidence of brain swelling, steroids will be given. The role of steroids in managing adult bacterial meningitis remains controversial. In some cases of Hib meningitis in children, IV steroids are used to decrease the possibility of hearing loss.
Acutely ill people with suspected bacterial CNS infection are treated with antibiotics that cover the most common organisms. The first dose usually is given within 30 minutes of being evaluated by a doctor in the emergency department, and, if possible, before the lumbar puncture. Once the results of the lumbar puncture are available, and the organism is identified, more targeted therapy with the most effective antibiotics is begun.
Treatment of a brain abscess is complex. Depending on the size and location, the drainage could be performed by a neurosurgeon. Antibiotic therapy is similar to that of bacterial meningitis.
Viral infections: Most of the viral infections go away on their own with a complete recovery. They do not require any specific treatment. The only exception to this is the herpes viruses. Special antiviral drugs are used to treat brain infections caused by herpes.
Igor Boyarsky, DO, FACEP, FAAEM
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