Klebsiella brain abscess in adults.
BACKGROUND
We analyzed the clinical manifestations and therapeutic outcomes of Klebsiella brain abscesses.


METHODS
The clinical data of 15 patients with Klebsiella brain abscesses, retrospectively collected over a 14-year period, were studied.


RESULTS
The 15 patients included 13 cases of Klebsiella pneumoniae infection and two cases of Klebsiella oxytoca. All but one case were community-acquired infections. Locations of all of these abscesses were supratentorial. 12 cases involved a single abscess, and three involved multiple abscesses. Gas formation was also found in two cases (13%). Common predisposing factors included metastatic spread, chronic otitis media and neurosurgical procedures. Among these 15 patients, 11 were treated surgically and four received antibiotics alone. In total, 11 patients survived and four died, with an overall mortality rate of 26.7%.


CONCLUSIONS
The clinical presentations and therapeutic outcomes varied according to the different Klebsiella species. While debilitating diseases were common in K. pneumoniae infections, they were not common in K. oxytoca infection. And while metastatic septic abscess is a well-known, devastating complication of K. pneumoniae septicemia, usually seen as a brain abscess with a gas-forming appearance, all of these K. oxytoca infections had both otogenic infections and more favorable outcomes.
Liliang
P C
PC
Dept of Neurosurgery and Neurology, Chang Gung Memorial Hospital, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan.
Lin
Y C
YC
Su
T M
TM
Rau
C S
CS
Lu
C H
CH
Chang
W N
WN
Lee
T C
TC
Chen
H J
HJ
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D001932:Brain Neoplasms / Q000150:complications / Q000556:secondary; D017714:Community-Acquired Infections; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification / Q000472:pathogenicity*; D007710:Klebsiella Infections / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D010033:Otitis Media / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
D000900:Anti-Bacterial Agents