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Updated: Aug 9, 2026

Intracranial Subarachnoidal Route of Infection for Investigating Roles of Streptococcus suis Biofilms in Meningitis in a Mouse Infection Model
Published on: July 1, 2018
[Cerebral infections due to anaerobic organisms (author's transl)]
Abstract:
Most of intracranial suppurations, especially those from E.N.T. origin, are secondary to anaerobic germs, which can be cocci Gram (+) or Gram (-), in association or not with aerobic bacteria. 97 cases have been observed between 1968 and 1979 at Lariboisière Hospital. When the bacteriological study was realised in correct conditions, anaerobic germs were found in more than 60% of cases, and less than 10 % of cultures were negative. A lower mortality (11 %) and morbidity (34 %) rates follow an improvement in bacteriological diagnosis. Anaerobic bacteria stay very susceptible to antibiotics, such as the association Penicilline-Metronidazole; now, we prescribe immediately such a therapeutic, and eventually modify it after having received the antibiogram. As a conclusion, the treatment of brain abscesses could be simplified: CT scan and a rigourous bacteriology make possible an accurate control and follow-up of the suppuration after simple punction.
Insights
Intracranial suppurations, often from E.N.T. sources, are frequently caused by anaerobic bacteria. Improved bacteriological diagnosis and antibiotic treatment, like Penicillin-Metronidazole, significantly reduce mortality and morbidity rates in brain abscess cases.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Context:
- Intracranial suppurations, particularly those originating from Ear, Nose, and Throat (ENT) infections, are a significant clinical challenge.
- These infections are often polymicrobial, with anaerobic bacteria playing a predominant role.
Purpose:
- To analyze the bacteriology of intracranial suppurations and evaluate the impact of improved diagnostic methods and antibiotic treatments.
- To assess the relationship between bacteriological findings, treatment strategies, and patient outcomes (mortality and morbidity).
Summary:
- A study of 97 intracranial suppuration cases observed between 1968 and 1979 revealed anaerobic germs in over 60% when bacteriological studies were performed correctly.
- Negative culture rates were below 10%, and improved bacteriological diagnosis correlated with lower mortality (11%) and morbidity (34%) rates.
- Anaerobic bacteria demonstrated high susceptibility to antibiotics, notably the Penicillin-Metronidazole combination, which is now a primary therapeutic choice, adjusted based on antibiogram results.
Impact:
- Enhanced bacteriological diagnosis and prompt antibiotic therapy, particularly with Penicillin-Metronidazole, have simplified the management of brain abscesses.
- The integration of CT scans and rigorous bacteriology allows for accurate monitoring and follow-up of intracranial suppurations post-punction, improving patient outcomes.
Related Concept Videos
Bacterial Meningitis
Cryptococcal Meningitis
Bacterial Meningitis I: Introduction
Bacterial Meningitis II: Pathophysiology
Encephalitis l: Introduction
Brain Abscess l: Introduction

