Predicting Efficiency of Brain Abscess Treatment

2Aug 2018

      Brain abscess is caused by an infection of the brain. High-risk patients are those suffer from left to right shunt congenital heart diseases, sinus infection, or immune deficiency. Fatality rate from brain abscess is 20%. Two effective treatments are antibiotics and surgery. Treatment results depend on several factors including the patient’s condition and type of infection such as gram-negative bacteria or mold.

      The study, aiming to assess influencing factors toward brain abscess treatment result, is a retrospective study of brain abscess patients during 1999-2013.

       Based on the study of 114 patients, successful treatment must score 13-15 on the Glasgow Coma Scale (OR 14.64; 95% CI 2.70-79.34; p =0.02). On the other hand, failed treatment would include the case of mold infection (OR 40.81; 95% CI 3.57-466.49; p =0.003), intraventricular rupture of brain abscess (OR; 5.50; 95% CI 1.34-22.49; p =0.017). It was also found that the wider the distance between abscess and cerebral ventricles the significantly less likelihood the intraventricular rupture of the brain abscess would occur (OR 0.62; 95%CI 0.45-0.87; p=0.005). Every case of intraventricular rupture of the abscess occurred where the distance between abscess and cerebral ventricles was less than 7mms (p <0.000).

       In conclusion, success rate of brain abscess treatment depends on the clinical condition of the patient, type of infection, and the risk of abscess rupture as well as prevention e.g. via surgery.

 


(a) MRI of intraventricular rupture of a brain abscess


(b) Diffusion weighted imaging of intraventricular rupture of a brain abscess


(c) Evidence of ruptured abscess via aspiration procedure

Dr. Thara Tuntanatip, Dr. Kanet Kanjanapradit, Assoc. Prof. Dr. Sakchai Saeheng, Asst. Prof. Dr. Thakul Oearsakul, and Dr. Ittichai Sakarunchai
Department of Surgery, Faculty of Medicine, Prince of Songkla University
E-mail: tsus4@hotmail.com
Source : http://rdo.psu.ac.th/


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