The use of corticosteroids as an adjunct in the management of brain abscess is controversial. While steroids clearly reduce the cerebral edema and mass effect that accompany an abscess, they may also have detrimental side effects. Experimentally, when administered during the early stages of cerebritis, steroids diminish the effectiveness of host defense mechanisms that help contain the infection. Overall, it would appear that steroids decrease both the rate and degree of capsule formation. Corticosteroids have also been shown to significantly reduce the degree of contrast enhancement on CT scans, particularly in the cerebritis stages. Therefore, in patients receiving steroids, reduction in contrast enhancement cannot be taken as a-priori evidence of abscess resolution. Corticosteroids should be reserved as a life-saving measure for patients in whom significant mass effect and/or cerebral edema pose an imminent threat to survival or are significantly debilitating. They should be tapered rapidly, as the clinical condition permits.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.