Brain abscess. The experience of 30 years

• Published in: Medicina clínica Vol. 130; no. 19; p. 736
• Main Authors: Gómez, Joaquín, García-Vázquez, Elisa, Martínez Pérez, Miguel, Martínez Lage, Juan Francisco, Gónzalez Tortosa, José, Pérez Espejo, Miguel Angel, Ruiz, Joaquín, Canteras, Manuel, Herrero, José Antonio, Valdés, Mariano
• Format: Journal Article
• Language: Spanish
• Published: Spain 24.05.2008
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Brain Abscess - diagnosis; Brain Abscess - epidemiology; Brain Abscess - microbiology; Child; Female; Humans; Male; Middle Aged
• ISSN: 0025-7753
• DOI: 10.1157/13121077

The aim of this study was to evaluate epidemiological and clinical aspects of brain abscess (BA) and changes in clinical patterns during the last 30 years. Observational study of a cohort of non-pediatric patients with BA admitted at a 944-bed hospital. Data collection from clinical records was done according to a standard protocol. We analysed epidemiological, clinical and microbiological data and localization as well as changes during a 30 year period divided in 2 equal length phases: 1976-1989 (P1), and 1990-2005 (P2). 108 patients with BA were included (mean age: 45 years; range: 12-86; > 40 years in 42.4% P1, and 71.4% in P2, p < 0.05); 66 patients were treated in P1 and 42 in P2 (annual incidence: 4-5 cases and 2-3 cases per 10(6) population in P1 and P2, respectively). A predisposing condition was identified in 86% cases with statistically significant differences (p < 0.05) in: otitis media (18.2% vs 2.4%); dental infection (3% vs 16.7%); penetrating cranial trauma (16.7% vs 0%); post-neurosurgery (15.1% vs 21.4%), in P1 and P2, respectively; microbiologic diagnosis was made in 76% (no statistical differences P1/P2). Clinical aspects statistically different in P1/P2: severely altered mental status (10.6% vs 0%); vomiting (37.9% vs 21.4%); focal neurological deficits (37.9% vs 71.4%). No statistically significant differences were found in other epidemiological, clinical, radiological, microbiological or outcome characteristics in P1/P2. In spite of a lower incidence in P2 and certain epidemiological and clinical differences in P1/P2, mortality and relapses rates have not significantly changed in a 30 year period.