Brain abscess at the Kenyatta National Hospital, Nairobi

Abstract

Objective: To study the aetiology, mode of presentation and outcome following treatment of brain abscesses at the Kenyatta National Hospital, Nairobi. Design: A retrospective study. Setting: Kenyatta National Hospital, Nairobi. Subjects: Sixty five patients with brain abscesses who were seen at Kenyatta National Hospital between January 1989 and December 1993. Results: Twenty patients died following surgery (30.7% mortality). Eight per cent of the patients who underwent surgery were serologically positive for the human immune deficiency virus (HIV). When these patients were excluded mortality was 25%. There were more male patients than females (ratio 2.4:1). Thirty eight per cent of the patients were children below the age of ten years. Trauma was the commonest cause of brain abscess. The aetiology was unknown in 24% of the cases. Twenty six patients who were HIV positive and had suspected brain abscesses were not included in this study because they did not undergo surgery. The commonest organisms isolated were Staphylococci, Streptococci, Klebsiella and Haemophylus influenzae. Sixty eight per cent of the patients had seizures. All the patients were diagnosed by computerised tomography (CT) scanning of the brain. Surgical treatment was by multiple burr hole aspirations and excision through craniotomy. Conclusion: Brain abscess is still a major cause of morbidity at the Kenyatta National Hospital with a high overall mortality of 30.7% during the period under study.