Brain abscess and congenital heart disease

One hundred and thirty-three cases of brain abscess over a period of 20 years (1967-1986) were reviewed and 25 (18.7%) of these were associated with congenital heart disease (CHD). Headache was the predominant clinical feature and anaerobic streptococci were the commonest pathogen isolated. Craniotomy and excision of the abscess and burrhole aspiration were the mainstay of treatment together with appropriate antibiotic therapy. The importance of early diagnosis and treatment had been highlighted and the relative merits of the two methods of treatment were discussed.