Intracranial Abscesses: Changes in Epidemiology and Management Over Five Decades in Merseyside

Sharma, Rewati Raman; Mohandas, K. M.; Cooke, R.P.D.

doi:10.1007/s15010-008-7359-x

Cited by 65 publications

(84 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The mean preoperative leukocyte count was 13 (median 12, range [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], and the mean preoperative C-reactive protein (CRP) was 87 (median 85, range <5-158). Imaging was performed on all patients including computer tomography (CT) (n=10), angiography (n=8), Child: *; brain and ear: ±; Imaging re-evaluated by radiologist in 2015: §; COM: chronic otitis media; CT: computed tomography; MRI: magnetic resonance imaging; A: angiography; B: brain scintigraphy; EAC: external auditory canal; RMO: Radical mastoid operation; died due to abscess: † brain scintigraphy (n=3), and magnetic resonance imaging (MRI) (n=2).…”

Section: Microbiology Laboratory Tests and Radiological Examinationsmentioning

confidence: 99%

See 1 more Smart Citation

Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

Laulajainen‐Hongisto¹,

Aarnisalo

Lempinen³

et al. 2017

Int Adv Otol

View full text Add to dashboard Cite

OBJECTIVE:To evaluate the predisposing factors for otogenic intracranial abscesses, assess their changes over time, and analyze how they differ from those due to other causes. MATERIALS and METHODS:The medical records of all patients treated for otogenic intracranial abscesses, between 1970 and 2012 at a tertiary referral center, were retrospectively analyzed. The analysis included patient demographics, clinical characteristics, causative pathogens, treatments, outcomes, and comparisons of otogenic and non-otogenic intracranial abscesses. RESULTS:Of all intracranial abscesses, 11% (n=18) were otogenic. In the 1970s, otogenic infections were a common predisposing factor for intracranial abscess; but within our study period, the incidence of otogenic intracranial abscesses decreased. Most (94%) otogenic cases were due to chronic suppurative otitis media and 78% were associated with cholesteatoma. Most patients (94%) had ear symptoms. The most common presenting symptoms were discharge from the infected ear (50%), headache (39%), neurological symptoms (28%), and fever (17%). The most common pathogens belonged to Streptococcus spp. (33%), Gram-negative enteric bacteria (22%), and Bacteroides spp. (11%). Neurosurgery was performed on all patients, 69% of which were prior to a later ear surgery. Surgery of the affected ear was performed on 14 patients (78%). A favorable recovery was typical (78%); however, one patient died. CONCLUSION:Otogenic intracranial abscesses were most commonly due to a chronic ear infection with cholesteatoma. Ear symptoms and Gram-negative enteric bacteria were more common among patients with otogenic than non-otogenic intracranial abscesses.

show abstract

Section: Microbiology Laboratory Tests and Radiological Examinationsmentioning

confidence: 99%

“…The development of more effective treatments for AOM and its complications has resulted in fewer chronic ear problems, at least in the developed countries [3,5,[8][9][10][11][12] . The incidence of otogenic IAs has been decreasing [13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

Laulajainen‐Hongisto¹,

Aarnisalo

Lempinen³

et al. 2017

Int Adv Otol

View full text Add to dashboard Cite

show abstract

“…8 The following case report serves as a salient reminder of this danger of untreated dental disease.…”

Section: Introductionmentioning

confidence: 98%

“…[5][6][7] Brain abscesses occur more frequently in men than in women. 5,7,8 Odontogenic brain abscesses in children are virtually unheard of. The advent of computed tomography (CT) technology and magnetic resonance imaging (MRI) has greatly improved the diagnosis of brain abscesses and consequently reduced the rate of mortality.…”

Section: Introductionmentioning

confidence: 99%

A case of odontogenic brain abscess arising from covert dental sepsis

Clifton

Kalamchi

2012

annals

View full text Add to dashboard Cite

Odontogenic infections can spread to any organ of the body and in some cases cause life threatening infections. We report a case of multiple odontogenic brain abscesses resulting from undetected tooth decay. Whereas most odontogenic brain abscesses occur following dental treatment, this report documents brain abscesses prior to dental treatment, signifying the dangers of covert dental infections. This case report updates the literature on the topic of odontogenic brain abscesses.Odontogenic infections are known to spread throughout the body and cause distant organ failure and life threatening infections (eg endocarditis, meningitis and Ludwig's angina).1-4 Brain abscesses are of particular concern because of the potentially debilitating sequelae. Their incidence in the US is cited as 1:100,000 annually. 3 The prevalence of odontogenic brain abscesses ranges between 3% and 10% of all cases. [5][6][7] Brain abscesses occur more frequently in men than in women. 5,7,8 Odontogenic brain abscesses in children are virtually unheard of. The advent of computed tomography (CT) technology and magnetic resonance imaging (MRI) has greatly improved the diagnosis of brain abscesses and consequently reduced the rate of mortality.5 However, the outcome of treatment is still haunted by death or permanent handicap. 8 The following case report serves as a salient reminder of this danger of untreated dental disease. case historyA 56-year-old man was taken to a remote hospital by his co-worker because he arrived at work looking unwell and had mental changes. The patient's medical history was significant for hypertension, cholecystectomy and obstructive sleep apnoea with lisinopril, losartan and furosemide as his daily medications. He had recently experienced a dry cough for more than one month that was attributed to lisinopril being added to his prescribed medications. At about the same time he developed an intermittent fever. One week before presentation he experienced tunnel vision and memory lapse of recent events. Over the one-month time period he had a headache that progressively grew worse. Five days prior to presenting at hospital he developed pain in his neck and back with nausea and vomiting. His wife reported that six months earlier he had a toothache on his left side that resolved without treatment.CT showed multiple intracranial mass effect lesions and hydrocephaly. Vancomycin, aciclovir and ceftriaxone were administered before the patient was flown to a level 1 trauma centre for a higher level of care with the suspicion of brain abscess versus neoplasm. There he was found to be sleepy but making intentional movements such as pulling out his urinary catheter. He moved all extremities spontaneously and withdrew from noxious stimuli. His pupils were sluggish to non-reactive and miotic. Nuchal rigidity was unclear. Aciclovir and lisinopril were discontinued and fluconazole was started.The patient had bilateral external ventricular drains inserted, was placed on mechanical ventilation, had a subclavian central cathete...

show abstract

“…In contrast, linezolid (LZD) has satisfactory central nervous system (CNS) penetration and is an excellent candidate for the treatment of intracranial infections. 15) We describe two cases of intracranial MRSA infection successfully treated with LZD.…”

Section: Introductionmentioning

confidence: 98%

Linezolid Treatment for Intracranial Abscesses Caused by Methicillin-Resistant Staphylococcus Aureus -Two Case Reports-

Saito

Aoki

Sakurai

et al. 2010

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Two patients were treated for intracranial infections involving methicillin-resistant Staphylococcus aureus (MRSA). A 30-year-old woman was admitted to our hospital for intracerebral hemorrhage related to arteriovenous malformation. After decompressive craniectomy, the patient developed an epidural abscess. MRSA was isolated from the pus culture. The infection did not improve after intravenous vancomycin (VCM) administration for 15 days. However, after administration of linezolid (LZD) for 14 days, the infection had improved, and the white blood cell count and C-reactive protein values had normalized. A 53-year-old woman had previously undergone 3 operations for craniopharyngioma before the age of 35 years. She was admitted to our hospital with fever and disturbance of consciousness. Magnetic resonance imaging with contrast medium revealed a brain abscess caused by MRSA. After 14 days of intravenous administration of VCM, the infection had not improved and intravenous administration of LZD was initiated. After administration of LZD for 14 days intravenously and 14 days orally, the infection had improved, and the white blood cell count and C-reactive protein values had normalized. VCM is highly effective against MRSA infection, but penetration into the central nervous system (CNS) is poor. LZD has good CNS penetration, so should be considered for secondline antibiotic therapy for VCM-resistant intracranial MRSA infection.

show abstract

Intracranial Abscesses: Changes in Epidemiology and Management Over Five Decades in Merseyside

Cited by 65 publications

References 13 publications

Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

A case of odontogenic brain abscess arising from covert dental sepsis

Linezolid Treatment for Intracranial Abscesses Caused by Methicillin-Resistant Staphylococcus Aureus -Two Case Reports-

Contact Info

Product

Resources

About