[Spontaneous brain abscess--bacteriology, therapy and prognosis]

Abstract

Spontaneous intracranial abscesses are quite rare in western industrial countries. According to the recently published papers, each neurosurgical centre is expecting 2 to 4 cases a year. Whereas in the last three years we only operated on one or two cases a year we treated 8 cases in the first ten months of 1994. Although this remarkable increase is not statistically significant, further observations seem to be indicated. In 5 cases the origin of the abscess remained unknown. 3 patients had odontogeneous focuses, 2 middle ear and 2 pulmonary infections. One patient was operated on for spontaneous liver abscess few days before. Streptococcus was found in 9 cases, Bacteroides, Nocardia and Rhodoturola in 1 case each. For one patient no pathogen could be detected. In regard of our results, minimal invasive neurosurgical aspiration of the abscess with adjacent longterm antibiotic therapy gives a good prognosis with little morbidity. In contrast the mortality rate rises if diagnostic procedures are delayed or if the detected microorganism is highly resistant to current antibiotics.