Infect Chemother.  2003 Oct;35(5):235-240.

Clinical Features and Prognostic Factors of Brain Abscess

• Choi HS
• Kim YK
• Lee JH
• Jung JY
• Choi SH
• Park YS
• Chin BS
• Han SH
• Park YS
• Cho JH
• Choi JY
• Chang KH
• Song YG
• Kim JM

Abstract

BACKGROUND: Brain abscess is a important infectious disease of the central nervous system, although the mortality has been reduced due to new antibiotics therapy and improved imaging techniques. MATERIALS amp; METHODS: Over a period of 17 years, from March 1986 to Feburary 2003, 110 patients were identified as having brain abscess at the Severance Hospital. Based on medical records, we reviewed these cases and investigated retrospectively the epidemiology, clinical findings, therapeutic modalities and prognostic factors of brain abscess.
RESULTS
There were 78 males and 32 females, and the mean age was 34.4 years. The most common location of brain abscess was the parietal lobe (24.5%), followed by temporal (20.9%) and frontal lobes (20.0%). Gram positive cocci were most frequently isolated as the causative microorganism. Tuberculous brain abscess were diagnosed in 6 (8.8%) cases. The common predisposing conditions were neurosurgery (21.8%), otitis media (10%) and congenital heart disease (8.2%). Headache (63.6%), fever (55.5%) and focal neurologic deficits (51.8%) were the common symptoms. Aspiration or open drainage was performed in 77 cases (70.0%), and excision was performed in 17 cases(15.5%). Thirty five (31.9%) patients had neurologic sequelae after treatment, and the mortality rate was 11.8%. Factors influencing mortality of brain abscess were mental status and multiple abscesses.
CONCLUSION
Brain abscess is still a critical infectious disease of the central nervous system with high mortality and morbidity in Korea. Active surgical procedures including aspiration, open drainage or excision, as well as antibiotic therapy, are needed for the proper management.

Keyword

Brain abscess; Clinical features; Prognostic factors; Brain; Abscess

MeSH Terms

Abscess
Anti-Bacterial Agents
Brain Abscess*
Brain*
Central Nervous System
Communicable Diseases
Drainage
Epidemiology
Female
Fever
Frontal Lobe
Gram-Positive Cocci
Headache
Heart Defects, Congenital
Humans
Korea
Male
Medical Records
Mortality
Neurologic Manifestations
Neurosurgery
Otitis Media
Parietal Lobe
Retrospective Studies
Anti-Bacterial Agents