Brain abscess: about a clinical series of 30 patients

A retrospective study was designed to ascertain the main clinical features of 30 patients admitted for brain abscess between 1989 and 2005. A contiguous source of infection was identified in 40% of cases, direct inoculation secondary to trauma or neurosurgery in 23,3%, and a distant source in 23,3%. Fever, headache and sensorial involvement were the main clinical manifestations. Temporal and frontal lesions were predominant. Microbiological information was available in only half of cases, prevailing polymicrobial and gram-positive bacterial infections. Most patients underwent surgical procedures (66.7%) and the rest received only medical therapy. During antimicrobial treatment, 6 patients (20%) suffered a serious adverse event that prompted discontinuation or change of therapy. Failure of treatment was observed in 40%, including 3 deaths (10%), non-programmed surgical drainage or reintervention (16.7%) and changes of the antimicrobial regimen (13.3%). Eight patients were discharged with sequels (26.7%), and during follow-up, 21% presented major events (death or brain abscess-related readmission).