Etiology of Brain Abscess in Patients Presenting to Neurosurgery Department of Lady Reading Hospital Peshawar

Authors

  • Mohammad Ishaq Department of Neurosurgery Lady Reading Hospital, Peshawar – Pakistan.
  • MUHAMMAD ISHFAQ Department of Neurosurgery, Lady Reading Hospital, Peshawar
  • MUHAMMAD SIDDIQUE Department of Neurosurgery, Lady Reading Hospital, Peshawar
  • Ikram Alam Department of Neurosurgery, Lady Reading Hospital
  • Muhammad Usman Department of Neurosurgery, Lady Reading Hospital

Keywords:

Brain abscess, Etiology,, Otitis media, Temporal and parietal lobes

Abstract

Objective: To determine the etiology of brain abscess in patients presenting to Neurosurgery Department of Lady Reading Hospital, Peshawar.
Materials and Methods: This retrospective study was conducted in Neurosurgery Department, Lady Reading Hospital, Peshawar from March 2015 to February 2016. All patients admitted with brain abscess were included in the study while patients with meningitis, encephalitis, subdural empyema, and tuberculoma were excluded. Patient’s age, gender, pre-operative symptoms and etiology of brainabscess were recorded on a designed Proforma from hospital charts.
Results: Out of 42 patients, males were 30 (71.42%) while females were 12 (28.58%). They were most common in first three decades, having total number of patients of 35 (83.33%) with the mean age of 30.15 ± 2 SD. The three most common pre-operative symptoms were fever, headache and vomiting. Most common sources of infect-ion were otitis media 20 (47.61%) and congenital heart diseases 7 (16.66%). In 31 (73.80%) patients temporal and parietal lobes were involved.
Conclusion: Brain abscess is common in young to middle age population due to unhygienic status of ears with malepredominance. Temporal lobe of the brain is most common site of abscessand majority of the patients present with nausea, vomiting, fever, signs of raised intracranial pressure and meningism.

References

1. Gadgil N, Patel AJ, Gopinath SP. Open craniotomy for brain abscess: A forgotten experience? Surg Neurol Int. 2013; 4: 34.
2. Seydoux C, Francioli P. Bacterial brain abscesses: fac-tors influencing mortality and sequelae. Clin Infect Dis. 1992; 15 (3): 394–401.
3. Mehnaz A, Syed A U, Salem A S, Khalid C N. Clinical features and outcome of cerebral abscess in congenital heart disease, J Ayub Med Coll Abbottabad, 2006; 18 (2): 21-24.
4. Chang Y T, Lu C H, Chuang M J, Huang C,Chuang Y C, Tsai N W, et al. Supratentorial Deep-Seated Bacte-rial Brain Abscess in Adults: Clinical Characteristics
and Therapeutic Outcomes: J Acta Neurol Taiwan, 2010; 19: 178-183.
5. Sheehan J P, Jane J A., Ray D K, Goodkin H P. Brain abscess in children:Neurosurg. Focus, 2008; 24 (6): 1-5.
6. Moortay R K, Rajshekar V. Management of brain abs-cess: an overview Neurosurg Focus, 2008; 24 (3): 1-6.
7. Alorij M. Brain abscess in Southern province of Saudi Arabia Kingdom. Professional Med J Feb. 2013; 20 (1): 030-033.
8. Louvois J D, Brown E M, Bayston R, Pople I K. The rational use of antibiotics in the treatment of brain abscess. British Journal of Neurosurgery, 2000; 14 (6): 525-530.
9. Babu M L, Bhasin S K, Kanchan. Pyogenic Brain Abs-cess and its Management. JK science March, 2002 (4): 21-23.
10. Martinello R A, Cooneya E L. Cerebellar Brain Abs-cess Associated with Tongue Piercing: Brief report. Journal of Clinical Infectious Diseases, 2003; 36: 32–4.
11. Masalma M A, Drancourt M, Dufour H, Raoult D, Fou-rnier P E. Mycoplasma hominis brain abscess following uterus curettage: a case report.Journal of Medical Case Reports, 2011; 5: 278.
http://www.jmedicalcasereports.com/content/5/1/278.
12. Çavusoglu H, Kaya R A, Turkmenoglu O N, Çolak I, Aydin Y. Brain abscess: analysis of results in a series of 51 patients with a combined surgical and medical appr-oach during an 11-year period. Neurosurg. Focus, 2008; 24 (9): 1-7.
13. Oyama H, Kito A, Maki H, Hattori K, Noda T, Wada K. Inflammatory index and treatment of brain abscess. Nagoya J. Med. Sci. 2012; (74): 313-324.
14. Erdogan E, Cansever T. Pyogenic brain abscess. Neuro-surg Focus, 2008; 24 (2): 45-48.
15. Mamelak AN, Mampalam TJ, Obana WG, Rosenblum ML. Improvedmanagement of multiple brain abscesses: A combined surgical and medical approach. Neurosur-gery, 1995; 36: 76-86.
16. Mathisen GE, Johnson JP. Brain abscess. Clin Infect Dis. 1997; 25: 763-81.
17. Black P, Graybill JR, Charache P. Penetration of brain abscess by systemically administered antibiotics. J Neu-rosurg. 1973; 38: 705-9.
18. Carpenter J, Stapleton S, Holliman R. Retrospective analysis of 49 cases of brain abscess and review of the literature. Eur J Clin Microbiol Infect Dis. 2007; 26: 1-11.
19. Fischer EG. Mclennan JE, Suzuki Y. Cerebral abscess in children. Alii J Diseases Children, 198 t; 135 (8): 746-9.
20. Babu ML, Bhasin SK. Pyogenic brain abscess and its management, 2002; 4 (1): 34-8. 21. Lu CH, Chang WN, LIN YC, Liliang PC, Su TM, Rau CS. Bacterial brain abscess: microbiological features, epidemiological trends22. Keet PC. Cranial intradural abscess management of 641 patients during the 35 years from 1952 to 1986. Br J Neurosurg. 1990; 4: 273-8. 23. Qureshi HU, Siddiqui AA, Habib AA, Mozaffar T, Sar-wari AR. Predictors of mortality in brain abscess. JP-MA. 2002; 52: 111.
24. Bell WE. Treatment of fungal infection of the central nervous system. Ann Neurol. 1981; 9: 417-22.
25. Bennett JE. Introduction to Mycoses. In: Mandell GL, Bennett JE, Dolin R,eds. Mandell, Douglas, and Ben-nett’s Principles and Practice of Infectious Diseases. 6th ed. Churchill Livingstone: Elsevier; 2005: 2935-8.
26. Carey ME. Infections of the Spine and Spinal cord. In: Youmans JR, ed. Youmans Neurological surgery 4th ed. vol. 5. Philadelphia: WB Saunders Co; 1996: 3270-304.
27. Scaravilli F. Parasitic and fungal infections of the ner-vous system. In: Adams JH, Corsellis Duchen LW, eds. Greenfield’s Neuropathology. London: Edward Arnold; 1984: 304-37.
28. Scaravilli F. Parasitic and fungal infections of the ner-vous system. In: Hume – Adams JH, Corsellis JAN, Duchen LW, eds. Greenfield’s Neuropathology. Lon-don: Edward Arnold; 1992: 400-46. 29. Yang SY, Zhao CS. Review of 140 patients with brain abscess, Surg. Neurol., 1993; 39: 290-6. 30. Lakshmi V. Rao RR, Dinakar I. Bacteriology of brain abscess: observations on 50 cases. J. Mcd. Microbiol., 3993; 38: 187-90. 31. ODonoghuc MA, Green HT, Shaw MD. Cerebral abs-cess on Merseyside 1980 – 1988. J. Infect. 1992; 25: 163-72.

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2018-10-04

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