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Intracranial abscesses: changes in epidemiology and management over five decades in Merseyside

R Sharma1, K Mohandas, R P D Cooke

  • 1Department of Medical Microbiology, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, UK. Rashmi.Sharma@sthk.nhs.uk

Infection
|January 14, 2009
PubMed
Abstract

Insights

Intracranial abscess incidence is decreasing, with fewer otogenic cases but a rise in MRSA. Brain abscesses after neurosurgery remain a concern, necessitating ongoing vigilance and updated treatment strategies.

Area of Science:

  • Neurology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Intracranial abscesses present complex diagnostic and management challenges.
  • Understanding trends in incidence, etiology, and outcomes is crucial for improving patient care.
  • Previous studies provide a historical context for evaluating contemporary patterns.

Purpose of the Study:

  • To review changes in intracranial abscess patterns over the last decade.
  • To compare current data with historical studies spanning four decades.
  • To identify evolving etiological factors and management outcomes.

Main Methods:

  • Retrospective review of case notes and laboratory records.
  • Inclusion of all intracranial abscess cases admitted between January 1995 and January 2005.
  • Comparison with two prior studies from the same regional neurosurgical unit.

Main Results:

  • Incidence decreased to an average of five cases per year, down from eight in prior decades.
  • Otogenic abscesses significantly declined (12.8%), while post-neurosurgical abscesses remained consistent (19.1%).
  • Methicillin-resistant Staphylococcus aureus (MRSA) emerged as a pathogen; mortality decreased to 19.1% from historical rates of 43% and 24%.

Conclusions:

  • Overall incidence of intracranial abscesses is decreasing on Merseyside.
  • Predisposing factors have shifted, with a notable decline in otogenic causes.
  • Post-neurosurgical abscesses and the emergence of MRSA are significant concerns requiring continued attention.

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