title: Streptococcal brain abscess: analysis of clinical features in 20 patients.
abstract: BACKGROUND
  To assess the clinical features and therapeutic outcomes of brain abscess caused by streptococci.
  
  
  METHODS
  Twenty patients, 18 males and 2 females, aged 3 to 76 years, collected over a 14-year period, have been identified at Kaohsiung Chang Gung Memorial Hospital.
  
  
  RESULTS
  Among these 20 patients, 13 had viridans streptococci infection alone, one had non-A, non-B, and non-D streptococci infection alone, and the other 6 had mixed infections each including streptococci. The locations of all of the abscesses were supratentorial. Among these patients, 18 had a single abscess and 2 had multiple abscesses. Underlying conditions were common in our patients, including head trauma, heart disease, otopharyngeal infection, and medical procedures. Nineteen patients were treated surgically and 1 was treated with antibiotics alone. Nineteen survived and 1 died, with an overall mortality rate of 5%.
  
  
  CONCLUSIONS
  The clinical presentations and underlying conditions varied according to the different streptococcal species. Streptococcal brain abscesses accounted for 17% of our cases with brain abscesses, and 30% of our streptococcal infections had polymicrobial infections. Although streptococcal brain abscesses were commonly associated with otopharyngeal infections or infectious endocarditis, they also appeared to be often related to neurosurgical events or medical procedures in recent years. Based on our study, prognosis is favorable with early diagnosis and prompt treatment.
authors.affiliation: Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.
authors.forename: T M
authors.initials: TM
authors.lastname: Su
authors.forename: Y C
authors.initials: YC
authors.lastname: Lin
authors.forename: C H
authors.initials: CH
authors.lastname: Lu
authors.forename: W N
authors.initials: WN
authors.lastname: Chang
authors.forename: P P
authors.initials: PP
authors.lastname: Liliang
authors.forename: C S
authors.initials: CS
authors.lastname: Rau
authors.forename: C L
authors.initials: CL
authors.lastname: Liang
authors.forename: Y D
authors.initials: YD
authors.lastname: Tsai
authors.forename: T J
authors.initials: TJ
authors.lastname: Lee
authors.forename: H J
authors.initials: HJ
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D015984:Causality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents