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Brain abscess: with special reference to infection by pseudomonas
S K Gupta1, S Mohanty, S C Tandon
1Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Abstract:
Eighty cases of brain abscess treated in the University Hospital, BHU, Varanasi, India have been reviewed. Chronic suppurative otitis media was the commonest cause, followed by compound injuries. The overall mortality was 15%. In seven cases the causative organism was pseudomonas, resistant to most antibiotics. Prior to the availability of CT the mortality was 23.3%; after the routine use of CT for diagnosis the mortality fell to 10%. A high mortality (57%) was observed in patients who had pseudomonas. The best results were in patients who had been managed by excision of the abscess capsule.
Insights
Brain abscesses treated at University Hospital, BHU, Varanasi, India, showed a 15% overall mortality. Early diagnosis with CT scans significantly reduced mortality, especially for Pseudomonas infections.
Area of Science:
- Neurology
- Infectious Diseases
- Surgical Pathology
Background:
- Brain abscesses are serious intracranial infections requiring prompt diagnosis and management.
- Eighty cases treated at University Hospital, BHU, Varanasi, India, were reviewed to identify causes, outcomes, and effective treatments.
- Chronic suppurative otitis media and head injuries were identified as primary etiological factors.
Observation:
- The overall mortality rate was 15%.
- Pseudomonas was identified as the causative organism in seven cases, exhibiting resistance to common antibiotics.
- A significant reduction in mortality from 23.3% to 10% was observed after the routine implementation of CT scans for diagnosis.
Findings:
- Patients with Pseudomonas infections had a high mortality rate of 57%.
- Excision of the abscess capsule was associated with the best patient outcomes.
- CT imaging played a crucial role in improving diagnostic accuracy and reducing mortality.
Implications:
- Early and accurate diagnosis using CT scans is critical for improving brain abscess patient survival.
- Management strategies should consider the specific causative organism, particularly antibiotic-resistant strains like Pseudomonas.
- Surgical intervention, including abscess capsule excision, appears to be a key factor in successful treatment outcomes.