Brain Abscesses Complicating Bacterial Meningitis-A Nationwide Cohort Study From the Netherlands

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Brain abscesses are rare but serious complications of bacterial meningitis.
• Systematic assessment of their clinical characteristics and outcomes is lacking.

Purpose of the Study:

• To determine the prevalence, causative pathogens, clinical features, treatment, and outcomes of brain abscesses in patients with bacterial meningitis.

Main Methods:

• Prospective Dutch national cohort study of community-acquired bacterial meningitis (2006-2023).
• Identification of brain abscess cases via physician diagnosis and confirmation through cranial imaging re-evaluation.

Main Results:

• Brain abscesses complicated 1.9% of bacterial meningitis episodes.
• The Streptococcus anginosus group showed the highest prevalence (52.4%).
• 14-day survival was 94%, but 71% had unfavorable outcomes; 16% required neurosurgical intervention.

Conclusions:

• While Streptococcus pneumoniae is a common cause, non-pneumococcal streptococci present a higher risk for brain abscess development.
• Brain abscesses in meningitis patients are linked to a significant risk of poor outcomes.