Clinical and radiological characteristics of brain abscess caused by Streptococcus species: a cross-sectional study

Abstract Background: Streptococcus species are mostly reported the predominant organisms causing brain abscess (BA), however, there is no article focusing on the characteristics of patients with BA caused by Streptococcus species to date. This study aimed to describe the clinical and radiological features of patients with BA caused by Streptococcus species. Methods: All patients who were hospitalized due to BA with intracranial pus culture result of Streptococcus species alone after neurosurgical intervention from May 2015 to August 2018 in Huashan Hospital in Shanghai were included in this study. The data of patient demographics, clinical and radiological presenting features, microbiological results, surgical and antimicrobial treatment, and outcomes were collected. Results: Thirteen patients (10 male, 3 female) of primary brain abscesses were involved. The most frequent clinical presentations included headache (76.9%), fever (38.5%) and limb weakness (38.5%).The radiological features of abscesses in these patients included singularity, big size, thick wall and obvious oedema. The average abscess diameter before surgery was 51.62±11.00mm. The mean thickness of abscesses wall was 5.23±1.78mm. The mean range of oedema and distance between abscess margin were 93.62±16.31mm, 26.38±8.03mm, respectively. The strains isolated in this study all belonged to the viridans group and showed high susceptibility to cefotaxime and levofloxacin. All patients had good outcomes at discharge. Conclusion: Patients with BAs caused by Streptococcus species had unspecific clinical signs, but specific radiological features, which might be helpful for early diagnosis.