Clinical Analysis of 27 Cases of Brain Abscess

Abstract

Objective: This study was undertaken to evaluate the clinical presentation, sources of infection, outcome and microorganisms involved in the brain abscess in our locality.Methods: The case notes, radiological results and laboratory records of all 27 patients who were diagnosed as a brain abscess in our institution between 1990 and 2005, were reviewed retrospectively.Results: The mean age of the 27 patients was 37.7 years and the ratio of male to female was 23:4. The common presenting symptoms were headache, pyrexia, and changed mental status. The temporal lobe was the commonest site (11) and the frontal lobe (8) was followed. The primary sources of infection were found in 11 cases (41%), and those were bacterial endocarditis (4), prior surgery (3), otic infection (2) and trauma (2). Surgical intervention was performed in 18 of 27 patients. Culture of material drained from abscess isolated 4 microorganism from 4 cases of the 18 patients. The isolates were Staphylococcus aureus, Streptococcus mitis, Pseudomonas auresinosa and Proteus mirabilis. Three patients were died (11%) and the causes of death were medullary failure and septicemia (one patient was discharged hopelessly).Conclusion: There was a relatively high incidence of negative culture rate (67%) compared with other studies and the reason would might administration of antibiotics prior to surgery.