Bacterial brain abscess in patients with nasopharyngeal carcinoma following radiotherapy: microbiology, clinical features and therapeutic outcomes

BMC Infectious Diseases

Cheng-Hsien Lu⁷  Hung-Chen Wang⁶  Chia-Te Kung⁵  Ben Yu-Jih Su¹  Ben-Chung Cheng¹  Yu-Jun Lin⁷  Hsin-Ching Lin²  Tai-Lin Huang¹  Hsueh-Wen Chang⁷  Chi-Ren Huang³  Wen-Neng Chang³  Nai-Wen Tsai³  Wei-Che Lin⁴  Peng-Hsiang Fang⁶ 

[1] Departments of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;Departments of Otorhinolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, 833, Taiwan;Departments of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;Departments of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan

关键词: Therapeutic outcome;    Nasopharyngeal carcinoma;    Bacterial brain abscess;   

Others  :  1159704
DOI  :  10.1186/1471-2334-12-204

 received in 2012-01-08, accepted in 2012-08-31,  发布年份 2012

【 摘 要 】

Background

This study aimed to analyze the clinical features, causative pathogens, neuro-imaging findings, and therapeutic outcomes of bacterial brain abscess in patients with nasopharyngeal carcinoma (NPC) following radiotherapy.

Methods

NPC patients with bacterial brain abscess were evaluated. Their clinical data were collected over a 22-year period. For comparison, the clinical features, causative pathogens, neuro-imaging findings, and therapeutic outcomes between NPC and non-NPC patients were analyzed.

Results

NPC accounted for 5.7% (12/210) of the predisposing factors, with Viridans streptococci and Staphylococcus aureus as the two most common causative pathogens. Significant statistical analysis between the two groups (NPC and non-NPC patients) included chronic otitis media (COM) as the underlying disease, post-radiation necrosis by neuro-imaging, and the temporal lobe as the most common site of brain abscesses. The fatality rate in patients with and without NPC was 16.7% and 20.7%, respectively.

Conclusions

NPC patients with bacterial brain abscess frequently have COM as the underlying disease. Neuro-imaging often reveals both post-radiation necrosis and the temporal lobe as the most common site of brain abscesses, the diagnosis of which is not always a straightforward process. Radiation necrosis can mimic brain abscess on neuro-imaging and pose significant diagnostic challenges. Early diagnosis and treatment is essential for survival.

【 授权许可】

   
2012 Fang et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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