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Volume 37, Number 4, August 2004

Community-acquired brain abscess in Taiwan: etiology and probable source of infection


Yuen-Hua Ni, Kuo-Ming Yeh, Ming-Yieh Peng, Yen-Yi Chou, Feng-Yee Chang
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC

Received: June 27, 2003    Revised: August 28, 2003    Accepted: October 24, 2003   

 

Corresponding author:

Dr. Feng-Yee Chang, Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, No.325, Sec 2, Cheng Kung Rd, Neihu, Taipei, Taiwan 114, ROC. E-mail: fychang@ndmctsgh.edu.tw This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Methods:

Brain abscess is a life-threatening infection caused by spread from infected parameningeal or remote foci. Historically, streptococci have been the predominant organisms reported while brain abscess metastatic from liver abscess caused by Klebsiella pneumoniae has been a more recent emerging problem. This study retrospectively analyzed the characteristics of community-acquired brain abscess admitted during an 11-year period. There were 17 men and 7 women with age from 20 to 82 years (median, 41 years). The most common source of infection was liver abscess, followed by otitic infection and sinusitis. The classic triad of fever, headache and focal neurologic deficit was noted in only 25% of cases. Spread of the abscess to multiple lobes was common (n = 6). The most commonly identified organisms were Streptococcus spp. (n = 7) and K. pneumoniae (n = 5). All 5 cases of K. pneumoniae brain abscess also had concomitant pyogenic liver abscess and 4 of them had diabetes mellitus. In this study, brain abscess was common in young patients and in patients with diabetes mellitus. In Taiwan, Streptococcus spp. and K. pneumoniae are leading etiologies for community-acquired brain abscess. Liver abscess is the most likely source of K. pneumoniae brain abscess.

 



 

Key words:

Brain abscess, Klebsiella pneumoniae, liver abscess, Streptococcus



 



 

J Microbiol Immunol Infect 2004;37:231-235.