Streptococcal brain abscess: analysis of clinical features in 20 patients

Su, Thung-Ming; Lin, Yi‐Hao; Lu, Cheng-Hsien; Chang, Wen-Neng; Liliang, Po-Chou; Rau, Cheng-Shyuan; Liang, Cheng‐Loong; Tsai, Yu-Duan; Lee, Tao-Jen; Chen, Hung-Jung

doi:10.1016/s0090-3019(01)00551-1

Cited by 21 publications

(10 citation statements)

References 20 publications

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“…19 20 Streptococcus viridans has been known as one of the prevalent pathogens with haematogenous spread secondary to infectious endocarditis, especially in individuals with pre-existing native valvular disease, or on prosthetic valves, and it also may invade the bloodstream after medical procedures to complicate infections at other sites. 21 Therefore, it may partly explain the high proportion of cases associated with meningitis in our study. Furthermore, deterioration in clinical status during hospitalisation was the consistent finding in patients who had subsequent IVRBA, and these signs are often overlooked.…”

Section: Discussionmentioning

confidence: 81%

Clinical features and predictive factors of intraventricular rupture in patients who have bacterial brain abscesses

Lee

Chang

et al. 2006

Journal of Neurology, Neurosurgery & Psychiatry

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Background: Intraventricular rupture of brain abscesses (IVRBA) remains a catastrophic and fatal complication of bacterial brain abscess (BBA). However, no information has been reported about the risk factors that are predictive of intraventricular rupture. Methods: This study was undertaken to determine the potential risk factors that are predictive of intraventricular ruptures in patients with BBA but without intraventricular rupture when arriving at the hospital. A comparison is also made between patients who already have IVRBA at the time of admission (initial IVRBA) and those who have the episode during hospitalisation (subsequent IVRBA). Results: 62 patients, including 45 who had initial IVRBA and 17 who had subsequent IVRBA, were examined.Stepwise logistic regression analysis showed that the adjusted risk of intraventricular rupture during hospitalisation for patients with multiloculated brain abscesses had an odds ratio (OR) of 4.2 (95% confidence interval (CI) 1.24 to 14.3; p = 0.02) compared with those without multiloculated brain abscesses (referent); a reduction of 1 mm in the distance between the ventricle and brain abscesses would increase the rupture rate by 10% (p = 0.006, OR 0.9, 95% CI 0.83 to 0.97). Conclusion: This study shows that if the abscess is deep seated, multiloculated and close to the ventricle wall, a reduction of 1 mm in the distance between the ventricle and brain abscesses will increase the rupture rate by 10%. Despite aggressive medical and surgical management shown in this series, many patients continue to progress poorly.

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Section: Discussionmentioning

confidence: 81%

Clinical features and predictive factors of intraventricular rupture in patients who have bacterial brain abscesses

Lee

Chang

et al. 2006

Journal of Neurology, Neurosurgery & Psychiatry

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“…[6] Predisposing condition for viridians streptococcal brain abscess include congestive heart failure, chronic otitis media, head injury with cerebrospinal fluid rhinorrhoea, sinusectomy and craniotomy followed by ventriculoperitoneal shunt placement. [7] Predisposing factors in our case are CHD, but without infective endocarditis and bad oral hygiene. Viridans streptococci are the prevalent pathogens with haematogenous spread secondary to cardiogenic origin or from infection of paranasal sinusitis.…”

Section: Introductionmentioning

confidence: 58%

Brain abscess due to Streptococcus oralis in an immunocompetent patient

Solanki

Subramanian

Lakshmi

et al. 2014

Indian Journal of Medical Microbiology

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“…The majority of abscesses are solitary and occur in the frontal lobe. Surgery is required in most patients, and the duration of antibiotic treatment ranges from 4 to 8 weeks (16,17). The SAG has recently been recognized as a common cause of brain abscesses, which were collectively identified with other streptococci as the viridians group streptococci in prior studies (4,13).…”

Section: Discussionmentioning

confidence: 99%

Culture-negative Brain Abscess with <i>Streptococcus intermedius</i> Infection with Diagnosis Established by Direct Nucleotide Sequence Analysis of the 16S Ribosomal RNA Gene

et al. 2012

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A 70-year-old woman developed a headache for a month followed by right upper limb weakness. CT scan and MRI showed multiple ring-enhancing lesions. An intracerebral aspiration of an abscess was performed, but culture results were negative. The nucleotide sequence analysis of the 16S rRNA gene from the specimens identified Streptococcus intermedius. Given this result, S. intermedius was cultured by enrichment culture, and its sensitivities to antibiotics were determined. The patient exhibited complete remission. Thus, 16S rRNA gene analysis was highly useful not only for pathogen identification with negative culture results but also for the appropriate selection of antibiotics.

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Streptococcal brain abscess: analysis of clinical features in 20 patients

Cited by 21 publications

References 20 publications

Clinical features and predictive factors of intraventricular rupture in patients who have bacterial brain abscesses

Clinical features and predictive factors of intraventricular rupture in patients who have bacterial brain abscesses

Brain abscess due to Streptococcus oralis in an immunocompetent patient

Culture-negative Brain Abscess with <i>Streptococcus intermedius</i> Infection with Diagnosis Established by Direct Nucleotide Sequence Analysis of the 16S Ribosomal RNA Gene

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