Epidemiology, diagnosis, and treatment of brain abscesses.

PURPOSE OF REVIEW: This article describes the epidemiology, diagnosis, and treatment of brain abscesses focusing on studies published in the past 2 years.

RECENT FINDINGS: In the recent literature, advances have been made in describing the disease, ancillary investigations, and treatment, mostly by combining previously available literature in meta-analyses. These studies identified Staphylococcus and Streptococcus species as the most frequent cause of brain abscess. New developments include the analysis of genetic risk factors for brain abscess, evaluation of shorter antibiotic courses, and the use of hyperbaric oxygen treatment. However, many studies in this field are limited by methodology and results are less helpful for clinical practice. Nevertheless, there has been a gradual improvement in the outcome of patients with brain abscess over the past 50 years, which might be driven by improved brain imaging techniques, minimally invasive neurosurgical procedures, and protocoled antibiotic treatment. Multicenter prospective studies and randomized clinical trials are needed to further advance treatment and prognosis in brain abscess patients.

SUMMARY: Our understanding of brain abscesses has increased by meta-analysis on clinical characteristics, ancillary investigations, and treatment modalities. Prognosis has improved over time, likely due to improved brain imaging techniques, minimally invasive neurosurgical procedures, and protocoled antibiotic treatment.