Abstract
BackgroundPatients with primary brain abscess often present with atypical symptoms, and the outcome varies. We investigated the demographic, laboratory, and neuroimaging features of patients with brain abscess at our hospital and identified factors associated with their outcomes.MethodsWe retrospectively collected the data of patients diagnosed with primary brain abscess at our hospital between January 2011 and December 2020. Their clinical characteristics, predisposing factors, laboratory and neuroimaging findings, treatment, and outcome were analyzed.ResultsOf the 57 patients diagnosed with primary abscess, 51 (89.47%) were older than 40 years, and 42 (73.68%) were male. Only eight patients (14.04%) showed the classical triad of headache, fever, and focal neurological deficit. Fifteen patients (26.31%) had comorbidities, of which diabetes mellitus was the most common. Positive intracranial purulent material cultures were obtained in 46.15% of the patients, and gram-negative enteric bacteria were found in 33.33% of them, with Klebsiella pneumoniae being the most frequently observed. Surgical treatment, most commonly in the form of stereotactic drainage, was received by 54.39% of the patients. Good outcomes were achieved in 75.44% of the patients. Multivariate logistic regression analysis showed that patients with headaches were more likely to have a poor outcome (odds ratio 6.010, 95% confidence interval 1.114–32.407, p = 0.037).ConclusionsMale patients and those older than 40 years were more susceptible to brain abscess than female patients and those younger than 40 years, respectively. Only a few patients showed the classical triad of clinical symptoms. Diabetes mellitus was the most common comorbidity. Positive intracranial specimens’ culture results were uncommon, with gram-negative enteric bacteria, especially Klebsiella pneumoniae, being the main organisms found. Most patients had a good outcome, and the presence of headache may influence the outcome.
Highlights
Patients with primary brain abscess often present with atypical symptoms, and the outcome varies
Clinical and neuroimaging data Data regarding the patients’ demographic characteristics, predisposing factors, clinical characteristics, symptom duration, neurological status at admission, blood and cerebrospinal fluid (CSF) examination results, culture results of blood, CSF or brain abscess purulent material, antibiotic treatment, type of surgery, number of abscesses, and location of the brain abscess on magnetic resonance imaging or computed tomography were extracted from electronic medical records
Clinical characteristics Fifty-seven patients were diagnosed with primary brain abscess during the study period
Summary
Patients with primary brain abscess often present with atypical symptoms, and the outcome varies. Laboratory, and neuroimaging features of patients with brain abscess at our hospital and identified factors associated with their outcomes. Brain abscess is a focal intraparenchymal infection characterized by an encapsulated collection of purulent material, immune cells, and other materials following bacterial. Huang et al BMC Infectious Diseases (2021) 21:1245 with primary brain abscess present with atypical symptoms, which renders diagnosis challenging. We retrospectively collected and analyzed the information of patients diagnosed with primary brain abscess at our hospital in the last ten years to determine the predisposing risk factors, clinical characteristics, and predictors of outcome
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