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Update and approach to patients with brain abscess
Lars Haukali Omland1, Henrik Nielsen2,3, Jacob Bodilsen2,3
1Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet.
Current Opinion in Infectious Diseases
|March 28, 2024
Summary
Brain abscess incidence is rising, particularly in older adults, with oral bacteria as common causes. Effective management requires multidisciplinary care, source control, and addressing long-term neurological issues.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Brain abscess epidemiology is evolving, posing significant management challenges.
- High mortality and neurological sequelae rates necessitate updated approaches.
- Increasing incidence observed, especially in elderly populations.
Purpose of the Study:
- To review recent advancements in brain abscess epidemiology.
- To discuss contemporary diagnostic strategies for brain abscess.
- To outline current treatment modalities for brain abscess.
Main Methods:
- Literature review of recent studies on brain abscess.
- Analysis of epidemiological trends and predisposing factors.
- Synthesis of diagnostic and therapeutic recommendations.
Main Results:
- Predisposing factors include dental/ENT infections, immunosuppression, and neurosurgery.
- Oral cavity bacteria, including anaerobes, are identified as predominant pathogens.
- Diagnosis integrates advanced imaging (MRI), surgical intervention, and microbiology.
- Treatment focuses on source control (aspiration/excision) and prolonged antimicrobial therapy.
Conclusions:
- Multidisciplinary approach is essential for acute and long-term brain abscess management.
- Neurosurgical source control is a critical component of treatment.
- Ongoing research is needed to refine diagnosis and treatment protocols.
