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

BMC Infectious Diseases

Research Article

Hsueh-Wen Chang¹  Ben-Chung Cheng²  Peng-Hsiang Fang³  Hung-Chen Wang³  Yu-Jun Lin⁴  Chia-Te Kung⁵  Ben Yu-Jih Su⁶  Tai-Lin Huang⁶  Chi-Ren Huang⁷  Nai-Wen Tsai⁷  Wen-Neng Chang⁷  Cheng-Hsien Lu⁸  Hsin-Ching Lin⁹  Wei-Che Lin^1,10 

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

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

DOI  :  10.1186/1471-2334-12-204

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

来源: Springer

【 摘 要 】

BackgroundThis 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.MethodsNPC 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.ResultsNPC 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.ConclusionsNPC 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】

Unknown   
© Fang et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.