Intracranial Suppuration at the Brazzaville Academic Hospital

Abstract

Background: Intracranial suppurations (ICS) due to banal germs are medical-surgical emergencies, despite their little removed frequency. Represented by abscesses and empyemas, their management has been improved by the combined contributions of new diagnostic and therapeutic methods. Objective: Appreciate the management of intracranial suppurations banal germ in our service. Material and methods: A retrospective study of 41 cases of intra-cranial suppurations was conducted at Brazzaville University Hospital, from January 2007 to June 2019. Diagnostic, therapeutic and evolution aspects have been studied. Results: They are divided into 24 empyemas, 8 abscesses and 9 associations abscess-empyema. The average age was 20.2 years old in general. The male predominance is noted in all groups. The sex ratio is 3.1 for all of these intracranial suppurations (ICS). They frequently complicated Oto-Rhino-Laryngology (ORL) infections (41.4%). The clinic was mostly represented by the Bergman's triad 51.2%, followed by headache 14.6% and seizures 12.2%. The lesions were predominant in supratentorial 97.5%. Frontal location was found in 67.4%. Germs were isolated in 29.4% of samples. There were 5 Streptococci, 3 Staphylococci and 2 Gram-negative Bacilli. The medico-surgical treatment indicated in 80.5% combined often probabilistic tri-antibiotherapy with the evacuation of the pus by the trepano-puncture. Evolution under this treatment was marked by healing in 90.2%. The lethality was 9.7%. Conclusion: The pursuit of the improvement of these infections requires the adequate treatment of their gateways, most of them loco-regional.

Intracranial Suppurations in Togo: Etiologies and Treatment

“…There was a diagnostic delay due to self-medication and also neglect of symptomatology by parents. The other factor is the similarity of intracranial suppuration with meningitis and malaria in our environments leading to diagnostic errors [5] [10]. In our series, 6 patients underwent a lumbar puncture for suspected meningitis.…”

“…While in Europe and North America they became rare (1 -3 cases per year) [2], in developing countries where socioeconomic conditions are unfavorable, the prevalence of intracranial suppuration remains high (10 -20 cases per year) [3]. The data often available are patchy with either only pediatric cases or a single type of intracranial suppuration (abscess or empyema) [4] [5]. They are mostly caused by otolaryngological infections [6] [7].…”