Sinogenic brain abscess

A retrospective analysis on 32 patients who were treated at Oxford University Hospitals for rhinosinusitis-induced brain abscesses between February 2013 and June 2020.

Results: Mean age of presentation was 45.83 for adults and 11.14 for children. The subdural collection was the most frequent abscess but 25% of patients had multiple sites of the collection; the majority were in the frontal lobe. The most commonly identified pathogens were Streptococcus milleri group and Staphylococcus aureus; 93.75% of the patients were treated with combined Ceftriaxone and Metronidazole for an average of 8 weeks.

Most patients received also prompt and aggressive surgical treatment with combined neurosurgical and ENT procedures in the majority; this was especially important in the case of subdural empyema, Streptococcus milleri infection, and direct intracranial spread of infection. More than half of the patients were treated with a single surgical procedure. Despite aggressive treatment, one-third of patients experienced long-term neurological sequelae; there were no deaths ¹⁾.