Donald F E, Firth J L, Holland I M, Hope D T, Ispahani P, Punt J A
Department of Neurosurgery, University Hospital, Nottingham, United Kingdom.
Br J Neurosurg. 1990;4(4):265-71. doi: 10.3109/02688699008992735.
Brain abscess was reviewed in 24 patients admitted to University Hospital, Nottingham over a period of 3 years. Chronic ear infection was the most common predisposing factor, but in 11 patients the focus of infection remained unknown. CT scanning, carried out in all patients, was negative in one patient with clinical signs of meningitis. Polymicrobial and anaerobic infections were common. Actinomyces species were isolated in mixed culture from seven patients; in five the abscess was located in the cerebellum. Therapy was most often a combination of surgical drainage and antimicrobial therapy with beta-lactam agents and metronidazole. Evidence suggests that cefotaxime may offer a suitable alternative to chloramphenicol and benzylpenicillin in the treatment of brain abscess.
对诺丁汉大学医院3年内收治的24例脑脓肿患者进行了回顾性研究。慢性耳部感染是最常见的诱发因素，但11例患者的感染源仍不明。所有患者均进行了CT扫描，1例有脑膜炎临床症状的患者扫描结果为阴性。多微生物和厌氧菌感染很常见。从7例患者的混合培养物中分离出放线菌属；其中5例脓肿位于小脑。治疗通常是手术引流与使用β-内酰胺类药物和甲硝唑的抗菌治疗相结合。有证据表明，头孢噻肟在治疗脑脓肿方面可能是氯霉素和苄青霉素的合适替代品。
