Zhang et al reported risk factors for mortality and recurrence of a brain abscess for a patient with a head and neck source. These can help to identify a patient who may benefit from more aggressive management. The authors are from Chongqing Medical University, Massachusetts General Hospital, and First Medical Center of Chinese PLA General Hospital.
Patient selection: brain abscess with a source in the head and neck
Sources of infection include:
(1) pansinusitis
(2) status post neurosurgery
(3) dental
(4) mastoid or ear
(5) status post head trauma
Predictors of recurrence:
(1) seizure activity
Predictors of mortality:
(1) advanced age (> 55 years)
(2) staphylococcal infection
(3) low monocyte percentage in differential count (< 4%)
(4) hyponatremia (< 135 mmol/L)
(5) elevated BUN (> 25 mg/dL) and/or serum creatine (> 1.5 mg/dL)
(6) hyperglycemia (blood glucose > 110 mg/dL)
(7) discharge status not complete resolution
