Epidemiological Trends in Brain Abscess: A Study at a Tertiary Care Centre

Background Despite the recent advances in diagnosis and management, brain abscess still remains a highly lethal lesion. It has been noted that there is little change in the incidence of brain abscess over the past 20 yrs. Aims To determine the current epidemiological trends, clinical presentation and commonest organism of brain abscess in this part of the country. Material and Methods 59 cases admitted during dec 2012 to june 2014 in the department of neurosurgery of SSH BHU, Varanasi were included in the study. Detailed clinical history was taken and detailed neurological examination was done including assessment by glasgow coma scale (GCS). Relevant laboratory investigations were done as needed along with CT scan and /or MRI. Patients were managed by aspiration or surgical excision and aspirated material sent for microbiological examination. Results were collected and analysed. Results Chronic suppurative otitis media (CSOM) was the commonest cause of infection in 31 patients (52.5 %). Trauma was encountered in 7 cases (11.8 %) with one having traumatic rhinorrhea. Other causes were haematogenous spread of infection from distant sites and meningitis. No source could be identified in 13 patients (22 %). Conclusion Chronic suppurative otitis media ( CSOM) is still a major cause of brain abscess in developing country like India which is a benign curable disease and should not be neglected. Prompt diagnosis and treatment allows immediate decompression of mass, reduces duration of antibiotic stay and minimizes treatment cost.