Community-acquired Intracranial Suppurative Infections: A 15-year Report

Overview

Journal Surg Neurol Int

Specialty Neurology

Date 2014 Oct 16

PMID 25317357

Citations 6

Authors

Taner Yildirmak

Habip Gedik

Funda Simsek

Arzu Kanturk

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to retrospectively evaluate the characteristics, treatment, and prognosis of patients with intracranial suppurative infection (ISI) by review of clinical, radiological, and laboratory findings.

Methods: The data collected from all patients who had been diagnosed with ISI and followed up at the Infectious Diseases and Clinical Microbiology Department of the study site between 1998 and 2013 were reviewed.

Results: Of the 23 ISI patients identified, the mean age was 38.21 ± 12.61 years (range: 19-67 years, median: 34) and mean symptom duration was 22.25 ± 20.22 days. Headache was the most common symptom, the frontal lobe the most common localization of ISI, and mastoiditis due to chronic suppurative otitis media the most common source of infection causing ISI. Proteus mirabilis, Pseudomonas spp., Peptostreptococcus spp., Enterococcus avium, Mycobacterium tuberculosis complex, and Toxoplasma gondii were isolated from the specimens collected from 6 (37.5%) of the 16 patients who underwent invasive procedures. Of these 16 patients, 2 underwent craniotomy, 12 burr hole aspiration, and 2 stereotactic biopsy. The rate of recurrence was 0% and the rates of sequelae and fatality were both 8%.

Conclusions: ISI should be considered in male patients presenting with headache and neurological signs and symptoms, whether with or without fever, on admission for early diagnosis and provision of timely, adequate therapy and, if required, surgical intervention to reduce mortality and sequelae rates.

Citing Articles

Non- non- enterococci: a review of clinical manifestations, virulence factors, and antimicrobial resistance.

Mullally C, Fahriani M, Mowlaboccus S, Coombs G Clin Microbiol Rev. 2024; 37(2):e0012123.

PMID: 38466110 PMC: 11237509. DOI: 10.1128/cmr.00121-23.

Unusual intracranial suppuration: illustrative cases.

Pradhan A, Rutayisire F, Munyemana P, Karekezi C J Neurosurg Case Lessons. 2022; 2(24):CASE21570.

PMID: 35855485 PMC: 9281436. DOI: 10.3171/CASE21570.

Management and Outcomes of Paediatric Intracranial Suppurations in Low- and Middle-Income Countries: A Scoping Review.

Ooi S, Sichimba D, Dalle D, Higginbotham G, Takoutsing B, Bankole N Front Surg. 2021; 8:690895.

PMID: 34466410 PMC: 8403063. DOI: 10.3389/fsurg.2021.690895.

Application of combined cerebrospinal fluid physicochemical parameters to detect intracranial infection in neurosurgery patients.

Zhai T, Fu Z, Qiu Y, Chen Q, Luo D, Chen K BMC Neurol. 2020; 20(1):213.

PMID: 32460716 PMC: 7251726. DOI: 10.1186/s12883-020-01781-6.

Complete genome sequence of bile-isolated strain 352.

Yu T, Li L, Zhao Q, Wang P, Zuo X Gut Pathog. 2019; 11:16.

PMID: 31049078 PMC: 6480912. DOI: 10.1186/s13099-019-0294-9.

References

Sharma R, Mohandas K, Cooke R . Intracranial abscesses: changes in epidemiology and management over five decades in Merseyside. Infection. 2009; 37(1):39-43. DOI: 10.1007/s15010-008-7359-x. View

Roche M, Humphreys H, Smyth E, Phillips J, Cunney R, McNamara E . A twelve-year review of central nervous system bacterial abscesses; presentation and aetiology. Clin Microbiol Infect. 2003; 9(8):803-9. DOI: 10.1046/j.1469-0691.2003.00651.x. View

Vieira J, Frank E, Spira T, Landesman S . Acquired immune deficiency in Haitians: opportunistic infections in previously healthy Haitian immigrants. N Engl J Med. 1983; 308(3):125-9. DOI: 10.1056/NEJM198301203080303. View

Jefferson A, Keogh A . Intracranial abscesses: a review of treated patients over 20 years. Q J Med. 1977; 46(183):389-400. View

Carpenter J, Stapleton S, Holliman R . Retrospective analysis of 49 cases of brain abscess and review of the literature. Eur J Clin Microbiol Infect Dis. 2006; 26(1):1-11. DOI: 10.1007/s10096-006-0236-6. View

Whitener D . Tuberculous brain abscess. Report of a case and review of the literature. Arch Neurol. 1978; 35(3):148-55. DOI: 10.1001/archneur.1978.00500270030007. View

Britt R, Enzmann D, Yeager A . Neuropathological and computerized tomographic findings in experimental brain abscess. J Neurosurg. 1981; 55(4):590-603. DOI: 10.3171/jns.1981.55.4.0590. View

GARFIELD J . Management of supratentorial intracranial abscess: a review of 200 cases. Br Med J. 1969; 2(5648):7-11. PMC: 1983029. DOI: 10.1136/bmj.2.5648.7. View

Brook I . Microbiology of intracranial abscesses and their associated sinusitis. Arch Otolaryngol Head Neck Surg. 2005; 131(11):1017-9. DOI: 10.1001/archotol.131.11.1017. View

10.

Seven H, Coskun B, Calis A, Sayin I, Turgut S . Intracranial abscesses associated with chronic suppurative otitis media. Eur Arch Otorhinolaryngol. 2005; 262(10):847-51. DOI: 10.1007/s00405-004-0903-0. View

11.

ODonoghue M, GREEN H, Shaw M . Cerebral abscess on Merseyside 1980-1988. J Infect. 1992; 25(2):163-72. DOI: 10.1016/0163-4453(92)93989-4. View

12.

Friedlander R, Gonzalez R, Afridi N, Pfannl R . Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 16-2003. A 58-year-old woman with left-sided weakness and a right frontal brain mass. N Engl J Med. 2003; 348(21):2125-32. DOI: 10.1056/NEJMcpc030011. View

13.

Gallagher R, Gross C, Phillips C . Suppurative intracranial complications of sinusitis. Laryngoscope. 1998; 108(11 Pt 1):1635-42. DOI: 10.1097/00005537-199811000-00009. View

14.

Fischl M, Pitchenik A, Spira T . Tuberculous brain abscess and Toxoplasma encephalitis in a patient with the acquired immunodeficiency syndrome. JAMA. 1985; 253(23):3428-30. View

15.

Chun C, Johnson J, Hofstetter M, Raff M . Brain abscess. A study of 45 consecutive cases. Medicine (Baltimore). 1986; 65(6):415-31. View

16.

Ramsey R, Gean A . Neuroimaging of AIDS. I. Central nervous system toxoplasmosis. Neuroimaging Clin N Am. 1997; 7(2):171-86. View

17.

Karandanis D, Shulman J . Factors associated with mortality in brain abscess. Arch Intern Med. 1975; 135(9):1145-50. View

18.

Tonon E, Scotton P, Gallucci M, Vaglia A . Brain abscess: clinical aspects of 100 patients. Int J Infect Dis. 2005; 10(2):103-9. DOI: 10.1016/j.ijid.2005.04.003. View

19.

Tsai H, Shin-Jung Lee S, Lin H, Lin W, Chen Y, Huang C . Treatment of Toxoplasma brain abscess with clindamycin and sulfadiazine in an AIDS patient with concurrent atypical Pneumocystis carinii pneumonia. J Formos Med Assoc. 2003; 101(9):646-9. View

20.

Akova M, Akalin H, Korten V, Ozgen T, Erbengi A . Treatment of intracranial abscesses: experience with sulbactam/ampicillin. J Chemother. 1993; 5(3):181-5. DOI: 10.1080/1120009x.1993.11739230. View