Surgically treated community-acquired brain abscess:

Bacteriological analysis based on predisposing infections

抄録

Community-acquired brain abscess is still encountered in clinical practice and causes considerable complications, despite improvements in hygiene in modernised societies. This study aimed to identify potential risk factors pertaining to predisposing infections and microorganisms to facilitate effective treatment of the brain abscess.

Of 121 surgically treated patients with brain abscess the most frequent predisposing condition was odontogenic infections (49/121 patients, 40.5%) followed by sinusitis (14/121, 11.6%). Of 121 patients, 51 (42.1%) had no identifiable predisposing infection. Viridans group streptococcus (VGS) was the most frequently identified (47%) bacteria in all patients, and anaerobes were more frequently isolated in patients with odontogenic infections (36.7%, p=0.001) than were aerobes. Among the patients with no identifiable predisposing infection, the most common isolated pathogen was VGS (38.3%), anaerobes were significantly less frequent (p=0.045) and old pulmonary tuberculosis was significantly common (p=0.001) comparing to the group with identified predisposing infections. There was only 1 case of staphylococcal infection of 121 patients. The present study indicates that VGS should be the first target for antibiotic treatment when predisposing infections are not identifiable in patients with brain abscess and association of old tuberculosis with community-acquired brain abscess is frequent.