Bacterial brain abscesses: An evaluation of 96 cases

Hakan, Tayfun; Ceran, Nurgül; Erdem, İlknur; Berkman, Mehmet Zafer; Göktaş, Paşa

doi:10.1016/j.jinf.2005.07.019

Cited by 95 publications

(129 citation statements)

References 40 publications

(111 reference statements)

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“…3) In another series, 19% of patients treated by aspiration underwent the procedure more than once. 5) A literature review spanning 78 years from 1930 to 2009 concluded that the high mortality from aspiration decreased dramatically after CT became available. 11) The mean mortality for aspiration post-1990 was 6.6% for series with more than five patients.…”

Section: Discussionmentioning

confidence: 99%

Aspiration Versus Excision: A Single Center Experience of Forty-Seven Patients With Brain Abscess Over 10 Years

Sarmast

Showkat

Kirmani

et al. 2012

Neurol. Med. Chir.(Tokyo)

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The efficacies of two different surgical approaches, aspiration and excision, were investigated for the management of large solitary encapsulated pyogenic brain abscess located in superficial non-eloquent areas, and the impact on length of hospital stay, duration of postoperative antibiotic use, improvement in neurological status, and morbidity and mortality were compared. This retrospective study at Sher-iKashmir Institute of Medical Sciences included 47 patients with pyogenic brain abscess from a total of 114 patients evaluated in the Department of Neurosurgery over a period of 10 years from October 2001 to October 2011. Comparisons were made between aspiration and excision in terms of duration of antibiotic use, length of hospital stay, and overall treatment cost. Aspiration was performed in 29 patients (61.7%), of whom 7 patients needed second aspiration, and 18 patients underwent excision (38.3%) of the abscess capsule. The mean duration of antibiotic use in the excision group was significantly shorter at 2.7 weeks (standard deviation [SD] ± 1.1) compared to the aspiration group at 3.8 weeks (SD ± 1.3) (p ＝ 0.006). Similarly, mean length of hospital stay was significantly shorter in the excision group at 18.1 days (SD ± 7.7) compared to the aspiration group at 24.9 days (SD ± 6.6) (p ＝ 0.002). In addition, significantly earlier improvement in neurological function (p ＝ 0.025) and significantly lower rate of re-surgery (p ＝ 0.0238) were found in the excision group compared to the aspiration group. Excision is better than aspiration as far as duration of antibiotic use, length of hospital stay, and overall cost of treatment is concerned, with no significant difference in morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Aspiration Versus Excision: A Single Center Experience of Forty-Seven Patients With Brain Abscess Over 10 Years

Sarmast

Showkat

Kirmani

et al. 2012

Neurol. Med. Chir.(Tokyo)

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“…Otogenic infection is still one of the most common causative factors in underdeveloped countries. 16,19,34 The source of infection may be unidentified in 25-38% of cases, with the resulting brain abscesses classified as "cryptic." 26,40,44 In the pediatric patient group, the most common predisposing factor is congenital heart disease or adjacent cranial infection.…”

Section: Pathogenesis and Diagnosismentioning

confidence: 99%

“…6,39,40,44 Seizure is also not uncommon as an initial symptom, occurring in 25-34% of patients. 2,16 In one case series involving pediatric patients, 27% of the patients presented with seizure, and none of them had a known history of febrile seizure or epilepsy. 12 …”

Section: Pathogenesis and Diagnosismentioning

confidence: 99%

“…16 The microbial investigation of the abscess material is one of the most important factors in the management of a brain abscess. 6 Gram staining is a simple but important technique that is not to be neglected.…”

Section: Laboratory Studiesmentioning

confidence: 99%

“…30 The most typically isolated microorganisms are Streptococcus and Staphylococcus species. 6,16,19,23,34,40,44 In a review of 130 cases, Tseng and Tseng 40 reported that multiple organisms were identified in 23% of patients. Goodkin et al 12 reported that Ͼ 1 organism was isolated in 39% of 36 positive cultures.…”

Section: Laboratory Studiesmentioning

confidence: 99%

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Management of bacterial brain abscesses

Hakan

2008

FOC

Self Cite

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✓ Brain abscesses are well-known lesions that have been reported from the beginning of the Hippocratic era. They continue, however, to be characterized by problematic and fatal features, even though there have been enormous developments in treatment and diagnostic technologies—especially in the areas of computed tomography (CT), surgery, anesthesia, bacterial isolation techniques, and new antibiotics. The predisposing factors may change according to patient age, geographic location, and socioeconomic conditions of the community, but patients frequently have a contiguous infection such as otitis or mastoiditis. The clinical signs and symptoms of brain abscesses are nonspecific. Patients typically present with signs and symptoms due to mass effects, accompanied by high fever and seizure. The main treatment is surgical, although medical therapy can be used for selected cases. The treatment of choice is aspiration, which may be performed with the aid of an endoscope or free hand, with or without stereotactic or intraoperative ultrasound guidance. Excision is valuable in some cases. The success of the treatment, whether surgical or medical, mostly depends on the success of isolation of the causative organism, which provides essential data for accurate medical treatment. Third-generation cephalosporins and metronidazole are the most commonly used antimicrobial agents in the treatment of brain abscesses. Use of corticosteroids may be acceptable when lesions are accompanied by edema. Prophylactic antiepileptic therapy is strongly recommended. The patient's Glasgow Coma Scale score at presentation is one of the most important factors predicting outcome.

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Ventricular empyema in a dog diagnosed by magnetic resonance imaging and immediate postmortem cerebrospinal fluid culture

Ashford,

Humphreys,

Phillipps

2024

Vet Record Case Reports

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A 1‐year 5‐month‐old, female, neutered springer spaniel presented collapsed in extensor rigidity. The dog had undergone ovariectomy 6 weeks previously, and a tooth root abscess was documented 2 months before this. Neurological signs were first reported 24 days after surgery, starting with lethargy and tremors, which progressed to generalised tonic‐clonic cluster seizures with inter‐ictal neurological deficits by 33 days after surgery. Magnetic resonance imaging of the brain revealed a conspicuous fluid–fluid level in the lateral ventricles consistent with ventricular empyema. Treatment was declined in favour of euthanasia, but postmortem cerebrospinal fluid sample showed marked pleocytosis with elevated protein and cultured a heavy growth of Staphylococcus pseudintermedius. The magnetic resonance imaging findings and positive cerebrospinal fluid culture were consistent with bacterial meningoencephalitis. Aetiology in this case was unknown, but may have been secondary to haematogenous spread, which is a rare but potential sequel to abdominal surgery, or intracranial extension of an oral infection.

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Bacterial brain abscesses: An evaluation of 96 cases

Cited by 95 publications

References 40 publications

Aspiration Versus Excision: A Single Center Experience of Forty-Seven Patients With Brain Abscess Over 10 Years

Aspiration Versus Excision: A Single Center Experience of Forty-Seven Patients With Brain Abscess Over 10 Years

Management of bacterial brain abscesses

Ventricular empyema in a dog diagnosed by magnetic resonance imaging and immediate postmortem cerebrospinal fluid culture

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