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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2021; 10(02): 095-102
DOI: 10.1055/s-0041-1725230
Review Article

Brain Abscess in the Current Decade (2010–2019) in India—A Review

R. Ravikumar
1   Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Daisy Vanitha John
1   Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
› Author Affiliations Funding The study was funded by Department of Science and Technology, Ministry of Science and Technology: http://dx.doi.org/10.13039/501100001409; SR/WOS-A/LS-472/2018. D.V.J. was supported by DST Women Scientists Scheme-A.
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Abstract

Brain abscess outcomes have improved in recent years due to advancements in cranial imaging, microbiological techniques, minimally invasive neurosurgical procedures, and effective antibiotic treatments. However, the incidence of brain abscess remains unchanged in developing countries. We searched PubMed and Google Scholar for references using the key words “brain abscess” and “India” and reviewed both retrospective and prospective studies published in peer-reviewed journals in the current decade to understand the present status. The review shows that the patients’ ages, the predominance of male patients, the symptoms and locations of brain abscesses, and the types of bacteria associated with them have remained unchanged over the past decade. The most common predisposing condition in recent years has been chronic suppurative otitis media with a mortality rate of 7 to 10%. Middle ear infection is often neglected and not treated aggressively in Asian countries. It requires multidisciplinary treatment strategies to address the primary source of infection and better health awareness to prevent the development of brain abscess.

Keywords

brain abscess - chronic suppurative otitis media (CSOM) - prevention


Publication History

Article published online:
13 May 2021

© 2021. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Brook I. Microbiology and treatment of brain abscess. J Clin Neurosci 2017; 38: 8-12
    CrossrefPubMedGoogle Scholar
  • 2 Brouwer MC, Coutinho JM, van de Beek D. Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology 2014; 82 (09) 806-813
    CrossrefPubMedGoogle Scholar
  • 3 Brouwer MC, van de Beek D. Epidemiology, diagnosis, and treatment of brain abscesses. Curr Opin Infect Dis 2017; 30 (01) 129-134
    CrossrefPubMedGoogle Scholar
  • 4 Khullar P, Datta NR, Wahi IK, Kataria S. Brain abscess mimicking brain metastasis in breast cancer. J Egypt Natl Canc Inst 2016; 28 (01) 59-61
    CrossrefPubMedGoogle Scholar
  • 5 Mian MA, Abbasi S, Khan FA, Usman M. Association of etiological and pathological features of brain abscess with outcome. Journal of Rawalpindi Medical College (JRMC) 2017; 21 (01) 29-32
    PubMedGoogle Scholar
  • 6 Lakshmi V, Umabala P, Anuradha K. et al. Microbiological spectrum of brain abscess at a tertiary care hospital in South India: 24-year data and review. Pathol Res Int 2011; 2011: 583139
    CrossrefPubMedGoogle Scholar
  • 7 Tomar V, Yadav A, Rathore RK. et al. Apparent diffusion coefficient with higher b-value correlates better with viable cell count quantified from the cavity of brain abscess. AJNR Am J Neuroradiol 2011; 32 (11) 2120-2125
    CrossrefPubMedGoogle Scholar
  • 8 Muzumdar D, Jhawar S, Goel A. Brain abscess: an overview. Int J Surg 2011; 9 (02) 136-144
    CrossrefPubMedGoogle Scholar
  • 9 Sarmast AH, Showkat HI, Bhat AR. et al. Analysis and management of brain abscess; a ten year hospital based study. Turk Neurosurg 2012; 22 (06) 682-689
    PubMedGoogle Scholar
  • 10 Bajpai A, Prasad KN, Mishra P, Singh AK, Gupta RK, Ojha BK. Distinct cytokine pattern in response to different bacterial pathogens in human brain abscess. J Neuroimmunol 2014; 273 (1-2) 96-102
    CrossrefPubMedGoogle Scholar
  • 11 Kothari M, Goel A, Muzumdar D. Brain abscess: heuristics, principles, pathobiology, practice. Neurol India 2015; 63 (03) 329-337
    CrossrefPubMedGoogle Scholar
  • 12 Naik RRM, Rao AL, Venugopal G. et al. Clinical study of brain abscess and its treatment with repeated aspirations and outcome. J EvolMed DenSci 2015; 4 (08) 1325-1331
    PubMedGoogle Scholar
  • 13 Sudhaharan S, Chavali P, Vemu L. Anaerobic brain abscess. Iran J Microbiol 2016; 8 (02) 120-124
    PubMedGoogle Scholar
  • 14 Borade VR, Jaiswal SA, Nemade HO. Transmastoid approach to otogenic brain abscess: 14 years experience. Ind J Otol 2011; 17 (04) 155-158
    CrossrefPubMedGoogle Scholar
  • 15 Suligavi SS, Gokale S, Jain P, Doddamani SS, Patil MN. Otogenic brain abscess: our experience. J Evol Med Den Sci 2015; 4 (13) 2087-2091
    PubMedGoogle Scholar
  • 16 Borgohain R, Talukdar R, Ranjan K. Otogenic brain abscess: a rising trend of cerebellar abscess an institutional study. Indian J Otol 2015; 21: 286-289
    CrossrefPubMedGoogle Scholar
  • 17 Bhattacharjee A, Singh RP, Nazrin J. Monitoring the evolution of otogenic brain abscess - changing trends in management. IOSR JDenMedSci 2016; 15: 36-47
    PubMedGoogle Scholar
  • 18 Mukherjee D, Das C, Paul D. Single-stage trans-mastoid drainage of otogenic brain abscess: a single-institution experience. Indian J Otolaryngol Head Neck Surg 2016; 68 (02) 179-184
    CrossrefPubMedGoogle Scholar
  • 19 Melkundi S, Melkundi RS. Otogenic brain abscess and its management with review of literature. Int J Otorhinolaryngol Head Neck Surg 2017; 3 (02) 180-183
    CrossrefPubMedGoogle Scholar
  • 20 Ong CT, Tsai CF, Wong YS, Chen SC. Epidemiology of brain abscess in Taiwan: a 14-year population-based cohort study. PLoS One 2017; 12 (05) 0176705
    PubMedGoogle Scholar
  • 21 Chowdhury FH, Haque MR, Sarkar MH, Chowdhury SMNK, Hossain Z, Ranjan R. Brain abscess: surgical experiences of 162 cases. Neuroimmunol Neuroinflamm 2015; 2 (03) 153-161
    CrossrefPubMedGoogle Scholar
  • 22 Amir S. Brain abscess: a clinical experience in a tertiary care hospital. Pak J Surg 2017; 33 (03) 203-207
    PubMedGoogle Scholar
  • 23 Ndubuisi CA, Ohaegbulam SC, Mezue WC, Chikani MC, Nkwerem SP, Ozor II. Management of brain abscess: changing trend and experience in Enugu, Nigeria. Niger J Surg 2017; 23 (02) 106-110
    CrossrefPubMedGoogle Scholar
  • 24 Azam F, Iftikhar-Ul-Haq M. Mushtaq. Clinical manifestation of brain abscess. Pak J Neurol Surg 2011; 15: 99-101
    PubMedGoogle Scholar
  • 25 Hsu CW, Lu CH, Chuang MJ. et al. Cerebellar bacterial brain abscess: report of eight cases. Acta Neurol Taiwan 2011; 20 (01) 47-52
    PubMedGoogle Scholar
  • 26 Ahmad S, Rehman L, Afzal A, Rizvi R. Outcome of burr-hole aspiration of brain abscess. Pak J Med Sci 2017; 33 (05) 1161-1165
    CrossrefPubMedGoogle Scholar
  • 27 Sonneville R, Ruimy R, Benzonana N. et al. ESCMID Study Group for Infectious Diseases of the Brain (ESGIB). An update on bacterial brain abscess in immunocompetent patients. Clin Microbiol Infect 2017; 23 (09) 614-620
    CrossrefPubMedGoogle Scholar
  • 28 Wiwanitkit S, Wiwanitkit V. Pyogenic brain abscess in Thailand. N Am J Med Sci 2012; 4 (06) 245-248
    CrossrefPubMedGoogle Scholar
  • 29 Savardekar AR, Krishna R, Arivazhagan A. Spontaneous intraventricular rupture of pyogenic brain abscess: a short series of three cases and review of literature. Surg Neurol Int 2016; 7 (Suppl. 39) S947-S951
    CrossrefPubMedGoogle Scholar
  • 30 Sáez-Llorens X, Nieto-Guevara J. Brain abscess. Handb Clin Neurol 2013; 112: 1127-1134
    CrossrefPubMedGoogle Scholar
  • 31 Hasegawa N, Sekizuka T, Sugi Y. et al. Characterization of the pathogenicity of Streptococcus intermedius TYG1620 isolated from a human brain abscess based on the complete genome sequence with transcriptome analysis and transposon mutagenesis in a murine subcutaneous abscess model. Infect Immun 2017; 85 (02) e886-16.pii:
    CrossrefPubMedGoogle Scholar
  • 32 Esen N, Kielian T. Toll-like receptors in brain abscess. Curr Top Microbiol Immunol 2009; 336: 41-61
    PubMedGoogle Scholar
  • 33 Ravikumar R, Nivedita P, Mridula RP, et al. Emerging pathogens causing brain abscess as seen in a Neurocare Centre, NIMHANS, Bangalore, South India. Paper presented at: XIX International Congress for Tropical Medicine and Malaria; September 18–22, 2016; Brisbane, Australia
    PubMed
  • 34 Bahubali VKH, Vijayan P, Bhandari V, Siddaiah N, Srinivas D. Methicillin-resistant Staphylococcus aureus intracranial abscess: an analytical series and review on molecular, surgical and medical aspects. Indian J Med Microbiol 2018; 36 (01) 97-103
    CrossrefPubMedGoogle Scholar
  • 35 Bajpai A, Prasad KN, Mishra P, Gupta RK, Singh AK, Ojha BK. Multimodal approach for diagnosis of bacterial etiology in brain abscess. Magn Reson Imaging 2014; 32 (05) 491-496
    CrossrefPubMedGoogle Scholar
  • 36 Miniar T, Amel BA, Khalil S. et al. Pyogenic brain abscess in children: a Tunisian multi-center experience. Afr Health Sci 2018; 18 (03) 560-568
    CrossrefPubMedGoogle Scholar
  • 37 Jenkins C, Ling CL, Ciesielczuk HL. et al. Detection and identification of bacteria in clinical samples by 16S rRNA gene sequencing: comparison of two different approaches in clinical practice. J Med Microbiol 2012; 61 (04) 483-488
    CrossrefPubMedGoogle Scholar
  • 38 Lleo MM, Ghidini V, Tafi MC, Castellani F, Trento I, Boaretti M. Detecting the presence of bacterial DNA by PCR can be useful in diagnosing culture-negative cases of infection, especially in patients with suspected infection and antibiotic therapy. FEMS Microbiol Lett 2014; 354 (02) 153-160
    CrossrefPubMedGoogle Scholar
  • 39 Al Masalma M, Lonjon M, Richet H. et al. Metagenomic analysis of brain abscesses identifies specific bacterial associations. Clin Infect Dis 2012; 54 (02) 202-210
    CrossrefPubMedGoogle Scholar
  • 40 Salzberg SL, Breitwieser FP, Kumar A. et al. Next-generation sequencing in neuropathologic diagnosis of infections of the nervous system. Neurol Neuroimmunol Neuroinflamm 2016; 3 (04) e251
    CrossrefPubMedGoogle Scholar
  • 41 Ratnaike TE, Das S, Gregson BA, Mendelow AD. A review of brain abscess surgical treatment–78 years: aspiration versus excision. World Neurosurg 2011; 76 (05) 431-436
    CrossrefPubMedGoogle Scholar
  • 42 Sarmast AH, Showkat HI, Kirmani AR. et al. Aspiration versus excision: a single center experience of forty-seven patients with brain abscess over 10 years. Neurol Med Chir (Tokyo) 2012; 52 (10) 724-730
    CrossrefPubMedGoogle Scholar
  • 43 Menon S, Bharadwaj R, Chowdhary A, Kaundinya DV, Palande DA. Current epidemiology of intracranial abscesses: a prospective 5 year study. J Med Microbiol 2008; 57 (Pt 10) 1259-1268
    CrossrefPubMedGoogle Scholar
  • 44 Kafle P, Sharma M, Shilpakar S. et al. Pediatric brain abscess clinical profile, management and outcome at tertiary care centre in Nepal. Journal of College of Medical Sciences-Nepal 2018; 14 (02) 102-106
    CrossrefPubMedGoogle Scholar
  • 45 Lee CG, Kang SH, Kim YJ. et al. Brain abscess in Korean children: a 15-year single center study. Korean J Pediatr 2010; 53 (05) 648-652
    CrossrefPubMedGoogle Scholar
  • 46 Zhang C, Hu L, Wu X, Hu G, Ding X, Lu Y. A retrospective study on the aetiology, management, and outcome of brain abscess in an 11-year, single-centre study from China. BMC Infect Dis 2014; 14: 311
    CrossrefPubMedGoogle Scholar
  • 47 Udayakumaran S, Onyia CU, Kumar RK. Forgotten? not yet. Cardiogenic brain abscess in children: a case series-based review. World Neurosurg 2017; 107: 124-129
    CrossrefPubMedGoogle Scholar
  • 48 Lee HS, Kim JH, Kim YH, Lee S. Surgically treated community-acquired brain abscess: bacteriological analysis based on predisposing infections. Jpn J Infect Dis 2018; 71 (03) 191-196
    CrossrefPubMedGoogle Scholar
  • 49 Ziaullah RZ. Brain abscess in children with cyanotic congenital heart disease-clinical presentation and outcome. JSMC 2017; 7 (02) 107-111
    PubMedGoogle Scholar
  • 50 Brouwer MC, van de Beek D. Management of bacterial central nervous system infections. Handb Clin Neurol 2017; 140: 349-364
    CrossrefPubMedGoogle Scholar
  • 51 Akashi M, Tanaka K, Kusumoto J, Furudoi S, Hosoda K, Komori T. Brain abscess potentially resulting from odontogenic focus: report of three cases and a literature review. J Maxillofac Oral Surg 2017; 16 (01) 58-64
    CrossrefPubMedGoogle Scholar
  • 52 Lajolo C, Favia G, Limongelli L. et al. Brain abscess of odontogenic origin in children: a systematic review of the literature with emphasis on therapeutic aspects and a new case presentation. Acta Otorhinolaryngol Ital 2019; 39 (02) 67-74
    CrossrefPubMedGoogle Scholar
  • 53 Gossman W, Tommeraasen MA, Cooper JS. Hyperbaric evaluation and treatment of intracranial abscess. Treasure Island (FL):. StatPearls Publishing 2019
    Google Scholar
  • 54 Mishra P, Prasad KN, Singh K, Sahu RN, Ojha BK. Association of ICAM-1 (K469E) and MCP-1 -2518 A>G gene polymorphism with brain abscess. J Neuroimmunol 2016; 292: 102-107
    CrossrefPubMedGoogle Scholar
  • 55 Mishra P, Prasad KN, Singh K, Bajpai A, Sahu RN, Ojha BK. Tumor necrosis factor-αand interleukin-1βgene polymorphisms and risk of brain abscess in North Indian population. Cytokine 2015; 75 (01) 159-164
    CrossrefPubMedGoogle Scholar