Clinical features and outcome of brain abscess after introduction of CT and MRI: A meta-analysis
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Published on: September 25, 2019
Jacob Bodilsen1, Emilie Marie Eriksen2, Mikkel Dreyer Nielsen2
1Department of Infectious Diseases, Aalborg University Hospital, 9000 Aalborg, Denmark; Institute for Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark; European Society of Clinical Microbiology and Infectious Diseases, Study Group for Infections of the Brain (ESGIB), Basel, Switzerland.
Objective:
To describe the clinical features and outcome of brain abscess since introduction of computerised tomography and magnetic resonance imaging.
Methods:
MEDLINE and Embase were searched using "brain abscess" or "cerebral abscess" from 1970 through 2023 and analyses restricted to study populations hospitalised after 1980. Single-variable meta-analyses were done using a random-effects model.
Results:
A total of 21,840 patients from 209 studies were included. The mean age was 34 years (95% confidence interval [CI] 30-38) and 11,817/17,406 (66%, 95% CI 64-67) were male. The aetiologies were consistent across time and continents with Streptococcus spp. 2064/6393 (32%, 95% CI 28-36), Staphylococcus spp. 1061/6393 (14%, 95% CI 12-16), and Gram-negative enteric bacteria 696/6393 (9%, 95% CI 7-11) as the most common. Predisposing conditions included otitis media/mastoiditis 1909/6433 (27%, 95% CI 22-33), immunocompromise 1022/4652 (19%, 95% CI 14-24), sinusitis 565/3725 (16%, 95% CI 12-20), and neurosurgery 745/4927 (16%, 95% CI 12-20). The case-fatality was 2444/18,991 (12%, 95% CI 11-14) and good recovery was found in 3419/5409 (63%, 95% CI 58-68).
Conclusions And Relevance:
Brain abscess remains a disease predominantly occurring in men and is caused by contiguous or distant infections. Case fatality and outcome have not improved during recent decades.
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