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Published in: BMC Infectious Diseases 1/2012

Open Access 01-12-2012 | Research article

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

Authors: Peng-Hsiang Fang, Wei-Che Lin, Nai-Wen Tsai, Wen-Neng Chang, Chi-Ren Huang, Hsueh-Wen Chang, Tai-Lin Huang, Hsin-Ching Lin, Yu-Jun Lin, Ben-Chung Cheng, Ben Yu-Jih Su, Chia-Te Kung, Hung-Chen Wang, Cheng-Hsien Lu

Published in: BMC Infectious Diseases | Issue 1/2012

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Abstract

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.
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Metadata
Title
Bacterial brain abscess in patients with nasopharyngeal carcinoma following radiotherapy: microbiology, clinical features and therapeutic outcomes
Authors
Peng-Hsiang Fang
Wei-Che Lin
Nai-Wen Tsai
Wen-Neng Chang
Chi-Ren Huang
Hsueh-Wen Chang
Tai-Lin Huang
Hsin-Ching Lin
Yu-Jun Lin
Ben-Chung Cheng
Ben Yu-Jih Su
Chia-Te Kung
Hung-Chen Wang
Cheng-Hsien Lu
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2012
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-12-204

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