Su Jiachun, Hu Bin, Zhang Yixin, Li Ying
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China.
Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
Heliyon. 2023 May 2;9(5):e16003. doi: 10.1016/j.heliyon.2023.e16003. eCollection 2023 May.
Brain abscess (BA) is a rare but life-threatening infection. Early identification of the pathogen is helpful to improve the outcomes. This study aimed to describe the clinical and radiological features of patients with BA caused by different organisms.
A retrospective, observational study of patients with known etiologic diagnosis of BA in Huashan Hospital Affiliated to Fudan University in China between January 2015 and December 2020 was conducted. Data on patient demographics, clinical and radiological presenting features, microbiological results, surgical treatment, and outcomes were collected.
Sixty-five patients (49 male, 16 female) with primary BAs were included. Frequent clinical presentations included headache (64.6%), fever (49.2%) and confusion (27.3%). viridans was associated with thicker wall of abscesses (6.94 ± 8.43 mm for viridans versus 3.66 ± 1.74 mm for other organisms, = 0.031) and larger oedema (89.40 ± 15.70 mm for viridans versus 74.72 ± 19.70 mm for other organisms, = 0.023). The independent factor associated with poor outcome identified by multivariate analysis was confusion (Odds ratio 6.215, 95% confidence interval 1.406-27.466; = 0.016).
Patients with BAs caused by species had nonspecific clinical signs, but specific radiological features, which might be helpful for early diagnosis.
脑脓肿（BA）是一种罕见但危及生命的感染。早期识别病原体有助于改善预后。本研究旨在描述由不同病原体引起的脑脓肿患者的临床和影像学特征。
对2015年1月至2020年12月期间在中国复旦大学附属华山医院确诊病因的脑脓肿患者进行回顾性观察研究。收集患者的人口统计学数据、临床和影像学表现特征、微生物学结果、手术治疗及预后等资料。
纳入65例原发性脑脓肿患者（男49例，女16例）。常见临床表现包括头痛（64.6%）、发热（49.2%）和意识障碍（27.3%）。草绿色链球菌与脓肿壁较厚相关（草绿色链球菌所致脓肿壁厚度为6.94±8.43mm，其他病原体所致为3.66±1.74mm，P = 0.031），且水肿范围较大（草绿色链球菌所致水肿范围为89.40±15.70mm，其他病原体所致为74.72±19.70mm，P = 0.023）。多因素分析确定与预后不良相关的独立因素是意识障碍（比值比6.215，95%置信区间1.406 - 27.466；P = 0.016）。
由草绿色链球菌引起的脑脓肿患者临床体征不具特异性，但具有特定的影像学特征，这可能有助于早期诊断。
