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[Current concepts in the management of pyogenic brain abscesses]
Kilani Badreddine1, Ammari Lamia, Mnif Emna
1Service des maladies infectieuses, Hôpital la Rabta, Tunis, Tunisie.
Abstract:
Brain abscesses are severe infections with lethal outcome in the case of delay in diagnosis and treatment. The authors report their experience about 30 patients with pyogenic brain abscesses treated between 1989 and 2000. The goal of the study is to analyse epidemiological, clinical and therapeutic aspects of this disease. The sex ratio (M:W) was 2,3 and the mean age was 34 years. Predisposing factors were sepsis of adjacent organs (53%) and bacteremia (30%). The clinical manifestations were: fever (83%), headaches (90%) and focal neurologic signs (57%). CT-scan findings were single lesions in 80% of cases. CT-scan showed a deep ring-enhancing lesion with surrounding edema in 77% of cases. Bacteriological agents in 13 cases (43%) were: 4 Staphylococcus aureus, 2 Neisseria meningitidis and 7 negative Gram bacilli. Medical treatment alone was in 77% of cases; seven patients benefited from medical and neurosurgical approaches. Death occured in 10% of cases.
Insights
Pyogenic brain abscesses are serious infections requiring prompt treatment to avoid lethal outcomes. This study analyzed 30 cases, highlighting key epidemiological, clinical, and therapeutic factors in brain abscess management.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Context:
- Brain abscesses present a significant diagnostic and therapeutic challenge, often leading to severe outcomes if treatment is delayed.
- Pyogenic brain abscesses are life-threatening infections requiring timely intervention.
- This study reviews a series of 30 patients treated over a 12-year period.
Purpose:
- To analyze the epidemiological, clinical, and therapeutic characteristics of pyogenic brain abscesses.
- To identify predisposing factors, common clinical presentations, and diagnostic findings.
- To evaluate treatment outcomes and associated mortality rates.
Summary:
- The study included 30 patients (M:W ratio 2.3, mean age 34 years) with pyogenic brain abscesses.
- Predisposing factors included adjacent organ sepsis (53%) and bacteremia (30%). Common symptoms were fever (83%), headaches (90%), and focal neurologic deficits (57%).
- CT-scan revealed single lesions in 80% and ring-enhancing lesions with edema in 77%. Staphylococcus aureus, Neisseria meningitidis, and Gram-negative bacilli were identified pathogens. Medical treatment was primary (77%), with some combined medical and surgical approaches. Mortality was 10%.
Impact:
- Provides insights into the management of pyogenic brain abscesses, emphasizing the importance of early diagnosis and treatment.
- Contributes to understanding the clinical spectrum and outcomes of brain abscesses in a specific patient cohort.
- Informs clinical practice regarding diagnostic strategies and therapeutic interventions for brain abscesses.
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