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Brain abscess: clinical analysis of 53 cases
Pao-Tsuan Kao1, Hsiang-Kuang Tseng, Chang-Pan Liu
1Division of Infectious Diseases, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
Summary
Early diagnosis and surgical intervention improve outcomes for brain abscess patients. Prompt treatment, especially with imaging and antibiotics, is crucial for better results and reduced mortality.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Brain abscess is a serious condition with varied presentations.
- Predisposing factors include otic infections, head trauma, and bacterial endocarditis.
- Underlying conditions like diabetes and liver cirrhosis increase mortality risk.
Purpose of the Study:
- To analyze the clinical characteristics, management, and outcomes of brain abscess cases.
- To identify factors associated with improved prognosis and mortality.
Main Methods:
- Retrospective review of 53 brain abscess cases treated between 1991 and 2001.
- Analysis of patient demographics, symptoms, predisposing factors, and underlying diseases.
- Evaluation of diagnostic methods (CT, MRI) and treatment strategies (surgery, antibiotics).
Main Results:
- Fever, headache, and altered mental status were common symptoms.
- Otic infection, head trauma, and endocarditis were frequent predisposing factors.
- Combined surgical and antibiotic treatment showed better outcomes than antibiotics alone; mortality was 45% with medical treatment alone.
Conclusions:
- Early diagnosis via neuroimaging (CT/MRI) is vital.
- Optimal surgical timing and appropriate antibiotic use are associated with improved outcomes.
- A high index of suspicion is necessary for timely intervention in at-risk patients.