Pyogenic brain abscess and subdural empyema: presentation, management, and factors predicting outcome

Widdrington, John; Bond, Helena; Schwab, Ulrich; Price, David Ashley; Schmid, Matthias; McCarron, Brendan; Chadwick, David; Narayanan, Manjusha; Williams, John E.; Ong, Edmund

doi:10.1007/s15010-018-1182-9

Cited by 51 publications

(57 citation statements)

References 28 publications

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“…Headache, fever were the most common symptoms in BA from the previously published data [11,12], and they were also observed in 76.9% and 38.5% of patients in this study, following limb weakness (38.5%), vomiting (23.1%), and walking unstable (23.1%). No seizure was presented in these patients.…”

Section: Discussionsupporting

confidence: 78%

Clinical and radiological characteristics of brain abscess caused by Streptococcus species: a cross-sectional study

Su¹,

Hu²,

Zhang³

et al. 2020

Preprint

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Background: Streptococcus species are mostly reported the predominant organisms causing brain abscess (BA), however, there is no article focusing on the characteristics of patients with BA caused by Streptococcus species to date. This study aimed to describe the clinical and radiological features of patients with BA caused by Streptococcus species. Methods: All patients who were hospitalized due to BA with intracranial pus culture result of Streptococcus species alone after neurosurgical intervention from May 2015 to August 2018 in Huashan Hospital in Shanghai were included in this study. The data of patient demographics, clinical and radiological presenting features, microbiological results, surgical and antimicrobial treatment, and outcomes were collected. Results: Thirteen patients (10 male, 3 female) of primary brain abscesses were involved. The most frequent clinical presentations included headache (76.9%), fever (38.5%) and limb weakness (38.5%).The radiological features of abscesses in these patients included singularity, big size, thick wall and obvious oedema. The average abscess diameter before surgery was 51.62±11.00mm. The mean thickness of abscesses wall was 5.23±1.78mm. The mean range of oedema and distance between abscess margin were 93.62±16.31mm, 26.38±8.03mm, respectively. The strains isolated in this study all belonged to the viridans group and showed high susceptibility to cefotaxime and levofloxacin. All patients had good outcomes at discharge. Conclusion: Patients with BAs caused by Streptococcus species had unspecific clinical signs, but specific radiological features, which might be helpful for early diagnosis.

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Section: Discussionsupporting

confidence: 78%

Clinical and radiological characteristics of brain abscess caused by Streptococcus species: a cross-sectional study

Su¹,

Hu²,

Zhang³

et al. 2020

Preprint

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“…Many causes of subdural empyema have been reported: otitis media, mastoiditis, and sinusitis were the most frequent primary foci. 1,18 Other causes are postcranial surgery and brain traumatic injury with an associated skull fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Infections of the central nervous system include meningitis, ventriculitis, empyema, and abscesses that can manifest with fever, vomiting, clinical deterioration, hydrocephalus, brain edema, and seizures requiring medical and surgical treatment to avoid complications. 1 The diagnosis and treatment of a subdural empyema are sometimes difficult due to the similar radiological characteristics to chronic subdural hematomas, and the treatment includes the evacuation of the collection associated with intravenous antibiotics. 2 Herein, we present the case of a patient with risk factors who developed a subdural empyema that was treated by surgical and medical means.…”

Section: Introductionmentioning

confidence: 99%

Subdural Empyema by Enterobacter cloacae: Case Report

Celi

Saal‐Zapata

2020

Indian Journal of Neurotrauma

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Infections of the central nervous system are a medical emergency, potentially lethal and associated with increased morbidity and mortality. We present the case of a male with risk factors and clinical deterioration, in which the brain computed tomography scan showed a subdural collection following a head injury, which underwent surgical evacuation revealing a subdural empyema. The culture of the subdural collection yielded a positive result to Enterobacter cloacae.

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“…Given that cavernous sinus is presumably susceptible to facial infection, orbital cellulitis and sinusitis are also known to cause intracranial abscess [7-9]. Brain abscess is a rare and life-threatening condition that typically originates from direct extension from nearby structures, hematogenous dissemination, or following penetrating cerebral trauma or neurosurgery [8,10]. Diagnosing brain abscess is challenging due to its nonspecific presentations.…”

Section: Discussionmentioning

confidence: 99%

Intracranial abscess from facial cellulitis

Park

Kim

et al. 2019

Arch Craniofac Surg

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Cellulitis, one of most common diseases of everyday life, is often overlooked for its significance. Although cellulitis does not cause or lead to serious problems usually, its possibility to cause lifethreatening problem should be known. In present case, a patient who had received acupuncture treatment a week earlier presented to the clinic with symptoms of facial cellulitis. The disease resolved within few weeks under empirical antibiotic treatment but recurred after 3 months. Under close history review of the patient, we found out that the patient had received craniectomy 20 years ago. The patient had blunt headache with no other neurological symptoms that could suspect cranial infection, but considering the risk originating from the patient's surgical history, brain computed tomography (CT) was taken. CT images revealed abscess formation in the subgaleal and epidural spaces. Craniotomy with abscess evacuation was done promptly. With additional antibiotic treatment postoperatively, the disease resolved, and the 1-month postoperative followup brain CT showed no signs of abscess formation.

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Pyogenic brain abscess and subdural empyema: presentation, management, and factors predicting outcome

Cited by 51 publications

References 28 publications

Clinical and radiological characteristics of brain abscess caused by Streptococcus species: a cross-sectional study

Clinical and radiological characteristics of brain abscess caused by Streptococcus species: a cross-sectional study

Subdural Empyema by Enterobacter cloacae: Case Report

Intracranial abscess from facial cellulitis

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