在临床工作中,有局灶感染史的脑脓肿及时诊断尚称不难。隐源性脑脓肿由于感染来源不明,临床表现较为复杂,往往误诊为颅内肿瘤等病,多在手术探查时确诊,有的死后尸检时才诊断脑脓肿。本文报告的四例中有两例以发烧、头痛就诊,把早期出现的精神症状、脑膜刺激征,误认为是病毒性脑炎或病毒性脑膜炎;把就诊较晚的两例,临床出现颅内高压症状、脑局灶体征,误认为颅内肿瘤或脑栓塞,以致延误诊断。例1:误诊为病毒性脑膜炎。女,25岁。15天 In clinical work, there is a history of focal infection in the brain abscess diagnosis is still not difficult to say. Cryptic brain abscess due to unknown origin of the infection, the clinical manifestations are more complicated, often misdiagnosed as intracranial tumors and other diseases, mostly confirmed in the surgical exploration, and some post-mortem diagnosis of brain abscess. Two cases of fever and headache were reported in this paper. The early symptoms of psychosis and meningeal irritation were mistakenly identified as viral encephalitis or viral meningitis. In the later two cases, the clinical appearance of cranial High pressure symptoms, signs of brain lesions, mistaken for intracranial tumors or cerebral embolism, resulting in delayed diagnosis. Example 1: misdiagnosed as viral meningitis. Female, 25 years old. 15 days