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Spontaneous brain abscess formation: challenge of a shifting pathogen spectrum over the last 21 years - a single

Luisa Mona Kraus1,2, Manou Overstijns3, Amir El Rahal3

  • 1Department of Neurosurgery, Medical Center University of Freiburg, Freiburg, Germany. luisamona.kraus@mri.tum.de.

Acta Neurochirurgica
|November 14, 2024
PubMed
Abstract

Insights

The spectrum of pathogens causing spontaneous brain abscesses is shifting towards rarer organisms like fungi and mycobacteria. Early microbiological diagnosis and combined surgical and antibiotic treatment are crucial for better patient outcomes.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Microbiology

Background:

  • Spontaneous intracerebral abscesses are rare but can lead to severe neurological deficits.
  • Infection origins, often from oral, sinus, or orbital sites, influence causative pathogens.
  • Treatment typically involves a combination of surgical intervention and antimicrobial therapy.

Purpose of the Study:

  • To analyze the changing microbiology of spontaneous intracerebral abscesses.
  • To evaluate treatment outcomes in patients undergoing surgical intervention.
  • To identify trends in causative pathogens over a 20-year period.

Main Methods:

  • Retrospective monocentric cohort study of 65 patients treated between 2000 and 2021.
  • Data extraction included demographics, clinical presentation, imaging, and treatment details.
  • Outcomes were assessed using the modified Rankin score (mRS).

Main Results:

  • An increasing prevalence of rare pathogens (fungi, parasites, mycobacteria, anaerobes) was observed.
  • Surgical and antibiotic treatment approaches were analyzed.
  • Patient outcomes, measured by mRS, remained consistent over the study period.

Conclusions:

  • The pathogen profile of spontaneous brain abscesses is evolving, with a rise in uncommon microorganisms.
  • Emphasizes the importance of accurate microbiological diagnosis.
  • Highlights the necessity of integrated surgical and antimicrobial treatment strategies.
Keywords:
Intracerebral abscessOdontogenic infectionRare pathogensSAG

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