An Eight Year Clinico-Microbiological Retrospective Study on Brain Abscesses in India

Abstract

Background: Intracranial abscesses have been a diagnostic and therapeutic challenge since time immemorial for both the microbiologists and the neurosurgeons. There is paucity of detailed studies documenting the infecting organism causing brain abscesses in South India. Aims: The study aimed at identifying and assessing the prevalence of aerobic, anaerobic bacteria and fungi associated with brain abscesses at a tertiary care hospital in South India. Methods and Material: Eight years data was collected from the records of culture reports from 2007 to 2010 and 2013 to 2018. The corresponding clinical case records were retrieved for the assessment of risk factors. Risk factors of brain abscess development were assessed based on clinical cases records. Results: Data from 140 brain abscess cases obtained over a period of 8 years were analyzed. Out of the 140 samples, 66 (47.14%) were culture positive in which 33 (50%) had single aerobic/facultative anaerobic bacteria, 20 (30.3%) had mixture of more than one aerobic/facultative anaerobic bacteria, 12 (18.18%) had single obligate anaerobic bacteria and 1(1.5%) sample had Mycobacterium tuberculosis isolated. Among the total 92 isolates, Pseudomonas aeruginosa (21/92, 23%) and Staphylococcus aureus (20/92, 22%) predominated. Bacteroides fragilis group was the most common obligate anaerobe isolated. There were no fungal isolates. As there were various isolates isolated, hence there is heterogeneity of isolates detected Neuroanatomically, parietal lobe (45/140, 32%) was the most common location. Otogenic infection was the major risk factor for parietal and temporal lobe abscess ( P value < .05). Conclusions: It has become essential for the microbiologists to be aware of unusual isolates from brain abscess and its complex nature. Obscurity and difficulty in their microbiological diagnosis calls for more such detailed studies.

Re-Operation Rates after Burr-Hole Aspiration of Brain Abscess

“…In a study conducted on the pediatric population in 2021 by Kanu et al, the most prevalent symptoms noted were headache (80%), fever (78%), and hemiparesis (78%). 11 Our study showed a similar trend of common presentation with headache (90.6% vs 93.3% at first presentation and 2 nd presentation for reaspiration respectively) being the most common symptom followed by fever (81.2% aspiration vs 53.3% re-aspiration), vomiting (51.5% aspiration vs 33.3% re-aspiration), seizures (32.8% aspiration vs 26.6% re-aspiration), ALOC (23.4% aspiration vs 20% re-aspiration) and focal neurological deficit (18.7% aspiration vs 0% re-aspiration). The clinical presentation of these abscesses is dependent on the size and location of the abscesses.…”

Concurrent Surgery Mastoidectomy and Craniotomy in Unsafe Chronic Suppurative Otitis Media with Intracranial Abscess

“…11 Otogenic infections are among the highest risk factors for brain abscess, according to Chetty et al, and chronic suppurative otitis media (CSOM) is one of the conditions that can lead to cerebellar brain abscesses. 12 According to the examination, the patient's otorrhea from the ear was never addressed. Otorrhea intermittently appears, is thick, yellow-green in color, and stinks.…”

“…Even radiological characteristics can occasionally be mistaken for brain tumors. 12,16 Pus builds up in the cerebrum or cerebellum and is known as an intracranial abscess. A pyogenic bacterium that develops as a result of an inflammatory process in the middle ear cavity is the cause.…”