Clinical Features and Prognostic Factors of Brain Abscess.
- Author:
Han Seok CHOI
1
;
Young Keun KIM
;
Jae Hyuk LEE
;
Ji Young JUNG
;
Suk Hoon CHOI
;
Yoon Seon PARK
;
Bum Sik CHIN
;
Sang Hoon HAN
;
Yoon Soo PARK
;
Jeong Ho CHO
;
Jun Yong CHOI
;
Kyung Hee CHANG
;
Young Goo SONG
;
June Myung KIM
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. jmkim@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Brain abscess;
Clinical features;
Prognostic factors;
Brain;
Abscess
- MeSH:
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
- From:
Infection and Chemotherapy
2003;35(5):235-240
- CountryRepublic of Korea
- Language:Korean
-
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.
