<![CDATA[Introduction: A cerebral abscess is a pus-filled, encapsulated area in the brain with risk of neurological deficit. MRI is the gold-standard modality for brain abscesses. Case Report: A 36-year-old woman came with progressively worsening headache for one year, accompanied by dizziness and nausea. Cranial nerve and motoric function were normal. Meningeal signs were negative. History of infection or trauma was denied. Contrast-enhanced MRI showed a lesion in the right cerebellum with rim enhancement. The patient was advised to be referred to neurosurgery, but declined. With conservative therapy of cefixime and dexamethasone, symptoms briefly reduced, but then came back. On latest examination we found unidirectional nystagmus to the right, positive Romberg test, left and right dysdiadochokinesia, with slight weakness in right arm (motoric 4+). Past pointing and intention tremor test was normal. Latest lab showed increased ESR.Discussion: Symptoms of a cerebral abscess are often non-specific. Abscess in the cerebellum is rare, most are located in the frontal or temporal lobes. Management of cerebral abscesses combines a medical and surgical approach. Intravenous antibiotics are preferred, but not feasible in our outpatient setting. Monitoring of treatment involves neurological exams, blood tests, and brain imaging. Conclusion: Conservative management of cerebral abscess are unusual and, although brief, the symptoms respond to the therapy. Monitoring is essential to adjust the treatment, but the lack of facilities in a primary hospital impedes the ideal treatment. The patient is urged to reconsider surgery given the latest outcome.]]>
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