[Brain abscess. The experience of 30 years].
OBJECTIVE
The aim of this study was to evaluate epidemiological and clinical aspects of brain abscess (BA) and changes in clinical patterns during the last 30 years.


METHODS
Observational study of a cohort of non-pediatric patients with BA admitted at a 944-bed hospital. Data collection from clinical records was done according to a standard protocol. We analysed epidemiological, clinical and microbiological data and localization as well as changes during a 30 year period divided in 2 equal length phases: 1976-1989 (P1), and 1990-2005 (P2).


RESULTS
108 patients with BA were included (mean age: 45 years; range: 12-86; > 40 years in 42.4% P1, and 71.4% in P2, p < 0.05); 66 patients were treated in P1 and 42 in P2 (annual incidence: 4-5 cases and 2-3 cases per 10(6) population in P1 and P2, respectively). A predisposing condition was identified in 86% cases with statistically significant differences (p < 0.05) in: otitis media (18.2% vs 2.4%); dental infection (3% vs 16.7%); penetrating cranial trauma (16.7% vs 0%); post-neurosurgery (15.1% vs 21.4%), in P1 and P2, respectively; microbiologic diagnosis was made in 76% (no statistical differences P1/P2). Clinical aspects statistically different in P1/P2: severely altered mental status (10.6% vs 0%); vomiting (37.9% vs 21.4%); focal neurological deficits (37.9% vs 71.4%). No statistically significant differences were found in other epidemiological, clinical, radiological, microbiological or outcome characteristics in P1/P2.


CONCLUSIONS
In spite of a lower incidence in P2 and certain epidemiological and clinical differences in P1/P2, mortality and relapses rates have not significantly changed in a 30 year period.
Servicio de Medicina Interna-Infecciosas. Hospital Universitario Virgen de la Arrixaca. El Palmar. Murcia. España.
Joaquín
J
Gómez
Elisa
E
García-Vázquez
Miguel
M
Martínez Pérez
Juan Francisco
JF
Martínez Lage
José
J
Gónzalez Tortosa
Miguel Angel
MA
Pérez Espejo
Joaquín
J
Ruiz
Manuel
M
Canteras
José Antonio
JA
Herrero
Mariano
M
Valdés
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001922:Brain Abscess / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged