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Bacterial brain abscess: risk factors for unfavourable outcome

Abstract number: 903_r2048

Popescu C.

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Objectives:

Despite the improvement of brain abscess management, the mortality rate is still high: 5–20%. The descriptions of involved factors are controversial.

Methods:

‘Matei Bals’ Infectious Diseases Institute database were utilised to identify all patients who had diagnosis of brain abscess during December 2001 to November 2003 period. We excluded the cases with definite or possible parasitosis (toxoplasmosis, cryptococcosis or cysticercosis). Subsequently, we evaluated the parameters correlated with mortality.

Results:

Ten patients (six females, four males) fulfilled the criteria. The mean age was 19.3 years, with 8/10 patients less than 30 years old. In a half of cases the aetiology was identified, and in 6/10 patients an ENT infection was the primary source of germs. The mean diagnosis delay was 10.5 days for ENT-related BA and 28.75 days for other cases (P = 0.02). Nine of 10 patients associated a meningitis and six of 10 fulfilled the criteria for sepsis. Three patients died: two in the first week of hospitalisation, and one after 25 days with no initial improvement. Neither age, clinical manifestations, initial adecvate antimicrobial regimen nor abscess dimensions were related to unfavorable outcome. All the ENT-related BA patients survived and only one from other four patients (P = 0.03); all patients with only one abscess survieved vs. 2/5 with multiple abscesses (P = 0.09).

Conclusion:

We identified two patterns in BA: the ENT-related are faster diagnosticated and the survival seems to be better. Multiple abscesses tend to be associated to a higher mortality.

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Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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