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Pyogenic brain abscess managed by repeated elective aspiration
U S Srinivasan1, R Gajendran, M J Joseph
1Department of Neurosurgery, PSG Institute of Medical Sciences and Research, Coimbatore, 641041, India.
Abstract:
37 cases of capsular stage of brain abscess based upon CT scan staging were treated by repeated elective aspiration through a burr hole and intracavitary application of antibiotics on alternate days, till two consecutive negative aspirations were obtained. A combination of furosemide and antibiotics in multiple doses were also given. The mortality rate was 2.7% and the morbidity rate 8.3%. Corticosteroids were not used in the management of brain abscess. Thus, repeated elective aspiration was found to be an effective mode of surgical management of brain abscess.
Insights
Repeated aspiration and antibiotics effectively treated brain abscess (37 cases). This surgical approach resulted in low mortality (2.7%) and morbidity (8.3%), avoiding corticosteroids.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Radiology
Background:
- Brain abscess is a serious intracranial infection.
- Accurate staging, such as CT scan staging, is crucial for effective management.
- Surgical intervention is often necessary for treatment.
Purpose of the Study:
- To evaluate the efficacy of repeated elective aspiration with intracavitary antibiotics for capsular stage brain abscess.
- To determine the mortality and morbidity rates associated with this treatment approach.
Main Methods:
- Treatment of 37 cases of capsular stage brain abscess using CT scan staging.
- Repeated elective aspiration via burr hole with alternate-day intracavitary antibiotic application until two consecutive negative aspirations.
- Administration of furosemide and antibiotics.
- Exclusion of corticosteroids from management.
Main Results:
- A low mortality rate of 2.7% was observed.
- A low morbidity rate of 8.3% was achieved.
- The treatment protocol was effective in managing brain abscess.
Conclusions:
- Repeated elective aspiration is an effective surgical management strategy for brain abscess.
- This method offers a favorable outcome with reduced mortality and morbidity.
- Corticosteroid avoidance is noted in this successful treatment regimen.