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Brain abscess and cerebritis.

G E Mathisen, R D Meyer, W L George

    Reviews of Infectious Diseases
    |March 1, 1984
    PubMed
    Summary
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    Brain abscess diagnosis and treatment improved with computerized axial tomography (CT) scans. However, high mortality persists, emphasizing the critical role of surgical drainage and anaerobic bacteria in brain infections.

    Area of Science:

    • Neurology
    • Infectious Diseases
    • Radiology

    Background:

    • Analysis of 18 consecutive brain abscess or cerebritis cases from 1970-1982.
    • Focus on 15 cases diagnosed after the introduction of computerized axial tomography (CT) in 1976.
    • Patient cohort included individuals with significant underlying medical conditions and identifiable infection sources.

    Observation:

    • Parietal lobe was the most common site of abscess in 14 patients.
    • Multiple brain abscesses occurred in 4 patients.
    • Microorganisms, including anaerobes, were isolated from 14 patients.

    Findings:

    • Therapy typically involved surgical drainage combined with antimicrobial agents.
    • Penicillin and chloramphenicol, or penicillin and metronidazole, were common drug regimens.

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  • Mortality rate was 22%, with one death in patients treated with antibiotics alone.
  • Two cases of bacterial cerebritis improved with chemotherapy alone.

    • Implications:

    • Reaffirms the significant role of anaerobic bacteria in brain abscess pathogenesis.
    • Computerized axial tomography (CT) enhances diagnosis and therapy monitoring but has not reduced mortality.
    • Surgical drainage remains the primary treatment for established brain abscesses, despite advances in antimicrobial therapy like metronidazole.