Clinical Aspects, Microbiological Features, and Therapeutic Outcome of Brain Abscess: An Experience of a Referral Center

Abstract

Background Brain abscess (BA) is recognized as a potentially fatal neurological infection requiring appropriate and prompt treatment. Improvements in diagnostic imaging and patient care have recently changed clinical symptoms, epidemiology, and outcomes. Therefore, we aimed to review all BA patients in our referral center. Method This study retrospectively reviewed all confirmed cases of BA referred to an academic teaching hospital and tertiary referral center between 2009 and 2021. Result The study included 119 clinically and radiologically confirmed brain abscesses (84% male vs. 16% female) with a mean age of 38.6 ± 16 years (range:1–79 years). The cause of BA in most cases (71.4%) was unknown. Only 11 patients had positive smears. Approximately 42.9% of patients were treated with surgery and antibiotic therapy, and the rest were treated with antibiotic therapy. The mortality rate in our study was 31.1%. Based on our analysis, HIV patients (P: 0.003), IV drug users (P: 0.025), and patients with loss of consciousness at the time of admission (P < 0.001) had a high mortality rate. On the other hand, patients treated with surgical intervention exhibited a low mortality rate (P: 0.02). The most common site of BA in our patients was the parietal (27.2%). Conclusion In our experience, HIV patients, IV drug users, and unconscious people on admission had higher mortality rates. The mortality rate of patients who underwent surgery was also low. The source of BA in most patients was unknown.