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The bacteriology of brain abscess: a local experience in Malaysia
S D Puthucheary1, N Parasakthi
1Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Abstract:
31 cases of intracranial abscess seen over a period of 10 years showed a peak incidence in the second and third decades of life with a male preponderance. Tetralogy of Fallot and other congenital cyanotic heart diseases were the predominant associated factors (32%). The commonest site of infection was the frontal lobe. Gram-stained smears of pus proved to be extremely useful. The majority of the organisms (82%) were either microaerophilic or anaerobic bacteria with Streptococcus milleri being the most frequent isolate. With the exception of Corynebacterium species, all isolates were susceptible to penicillin or chloramphenicol, most being susceptible to both.
Insights
Intracranial abscesses predominantly affect young males, often linked to congenital heart disease. Streptococcus milleri, an anaerobic bacterium, was the most common cause, with most bacteria susceptible to penicillin.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Intracranial abscesses are serious infections of the brain.
- Congenital cyanotic heart diseases are known risk factors for brain abscesses.
Purpose of the Study:
- To analyze the clinical characteristics, microbiological findings, and treatment outcomes of intracranial abscesses.
- To identify common causative organisms and their antibiotic susceptibility.
Main Methods:
- Retrospective review of 31 intracranial abscess cases over 10 years.
- Analysis of patient demographics, associated conditions, abscess location, and microbiological data.
- Evaluation of Gram-stain utility and antibiotic susceptibility patterns.
Main Results:
- Peak incidence in the second and third decades; male predominance observed.
- Congenital cyanotic heart disease was associated in 32% of cases.
- Frontal lobe was the most common site; Streptococcus milleri was the most frequent isolate (82% microaerophilic/anaerobic bacteria).
- Most isolates were susceptible to penicillin and chloramphenicol, except Corynebacterium species.
Conclusions:
- Intracranial abscesses in this cohort were associated with congenital heart disease and frequently caused by anaerobic bacteria.
- Prompt microbiological diagnosis and appropriate antibiotic therapy, primarily penicillin or chloramphenicol, are crucial for favorable outcomes.