Clinico-Epidemiological Profile of Brain Abscess- A Single Center Study

Abstract

INTRODUCTION: The overall incidence of bacterial brain abscess has remained relatively constant despite improved treatment of underlying systemic infections and development of more effective antibiotics. The systemic antibiotics are generally given for 6-8 weeks. The Choice of surgery varies from stereotactic aspiration /open surgical method including twist drill aspiration, burr hole aspiration with or without drainage, small craniectomy with aspiration and drainage to craniotomy and excision of abscess. The purpose of this article is to share authors’ experience regarding clinico epidemiological profile of brain abscess. MATERIAL AND METHODS: Total 30 patients with brain abscess who presented to the Department of Neurosurgery, PGIMER Dr. RML Hospital Delhi, from November 2016 to April 2018 analyzed for clinical, epidemiological, microbiological profile of brain abscess patients along with modes of treatment and their outcome. RESULTS: Total 30 patients of Brain Abscess were evaluated with males outnumbering females. Predominated symptoms were fever (96.7%), headache (83.3%) and nausea and vomiting (40%). The chronic suppurative otitis media (CSOM) was predominately underlying factor in 18 patients i.e. (60%) and commonest organism isolated was streptococcus pneumonia (66.6%) followed by streptococcus Milleri (33.33%). The length of hospital stay was longer in aspiration group {21.2 days (SD ± 4.1)} compared to excision group {13 days (SD ± 1.1)}. Total 20 (66.7%) patients survived, 2 (6.7%) patients died and 8 (26.7%) were lost to follow up. CONCLUSION: Majority of time there is an underlying factor for brain abscess. The treatment of brain abscess involves both medical and surgical modalities. Third generation cephalosporins and metronidazole are the most commonly used antimicrobial agents in the treatment of brain abscesses. The length of hospital stay in excision group was less as compared to medical group and aspiration group.