Brain abscess: clinical experience and analysis of prognostic factors

Brain abscess: surgical experiences of 162 cases

“…Abscesses of unknown cause accounted for 54.94% of the subjects, higher than the values reported for other series. [12,39,[41][42][43] In most large series of brain abscesses from developing countries, middle ear infection has been reported to be the most common source of intracranial suppuration, a result similar to the current study. [44] The basic principle of treatment is the prescription of appropriate antibiotics with or without aspiration, treatment of sequelae that is, hydrocephalus, seizures etc., and eradication of primary source.…”

Management of bacterial brain abscesses

“…16,19,34 The source of infection may be unidentified in 25-38% of cases, with the resulting brain abscesses classified as "cryptic." 26,40,44 In the pediatric patient group, the most common predisposing factor is congenital heart disease or adjacent cranial infection. 1,2,12,39 Recently, Auvichayapat et al 2 in their series of 107 cases involving infants and children, found chronic otitis media the second most common predisposing factor after congenital heart disease, and they concluded that this was probably due to the poor socioeconomic status leading to neglect of chronic otitis media, with children going without treatment for years.…”

“…1,2,12,39 Recently, Auvichayapat et al 2 in their series of 107 cases involving infants and children, found chronic otitis media the second most common predisposing factor after congenital heart disease, and they concluded that this was probably due to the poor socioeconomic status leading to neglect of chronic otitis media, with children going without treatment for years. Brain abscesses in patients with immunosuppression 12,40,44 and postneurosurgical nosocomial bacterial brain abscesses 45 are also increasing in incidence.…”

“…Headache, changes in level of consciousness, nausea and/or vomiting, and high fever are the most common manifestations. 6,39,40,44 Seizure is also not uncommon as an initial symptom, occurring in 25-34% of patients. 2,16 In one case series involving pediatric patients, 27% of the patients presented with seizure, and none of them had a known history of febrile seizure or epilepsy.…”

“…30 The most typically isolated microorganisms are Streptococcus and Staphylococcus species. 6,16,19,23,34,40,44 In a review of 130 cases, Tseng and Tseng 40 reported that multiple organisms were identified in 23% of patients. Goodkin et al 12 reported that Ͼ 1 organism was isolated in 39% of 36 positive cultures.…”