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Open Access Highly Accessed Research article

A retrospective study on the aetiology, management, and outcome of brain abscess in an 11-year, single-centre study from China

Chenran Zhang1, Liuhua Hu2, Xiaojun Wu1, Guohan Hu1, Xuehua Ding1 and Yicheng Lu1*

  • * Corresponding author: Yicheng Lu luyc305@163.com

  • † Equal contributors

Author Affiliations

1 Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, No. 415, Feng-Yang Road, Shanghai 200003, China

2 Department of Cardiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China

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BMC Infectious Diseases 2014, 14:311  doi:10.1186/1471-2334-14-311

Published: 6 June 2014

Abstract

Background

Brain abscesses continue to pose diagnostic and therapeutic challenges in developed and developing countries. Their aetiology and management remain complex and unclear, making improvement of treatments and outcome difficult.

Methods

To determine the demographics, management, and the variables that affect the outcome in subjects with brain abscesses treated at a single centre over an 11-year period, we retrospectively analysed data in 60 patients with brain abscesses surgically treated with stereotactically guided aspiration or open craniotomy excision in Shanghai Changzheng Hospital between January 2001 and December 2011. Such variables as age, gender, Glasgow Coma Scale (GCS) score at admission, clinical presentation, location, number of lesions, predisposing factors, mechanism of infection, aetiological agent, and therapy were analysed independently.

Results

Our analysis demonstrated that patient age and gender were factors that influence the occurrence of brain abscess; female patients and patients greater than 40 years of age were most likely to suffer a brain abscess. We also found that a patient’s GCS score upon admission did not influence outcome. While frequency of successful culturing of the infectious agent was low, positive cultures were obtained in only 8 of the cases (13.33%), in which the most common isolate was Streptococcus milleri. Outcome was favourable in 78.33% of the subjects, while the mortality rate was 20%. The outcome of one patient was poor due to the abscess in the basal ganglia region.

Conclusions

Stereotactically guided aspiration is an effective treatment for brain abscess with an overall favourable outcome. Mortality due to brain abscess was not directly related to surgery nor surgical technique. Additional studies will continue to reveal patients trends that may improve treatment for brain abscess.

Keywords:
Brain abscess; Chronic otitis media; Streptococcus milleri; Prognosis