Clinical characteristics and treatment of brain abscess in patients with hematological malignancies: A systematic review and meta-analysis.

OBJECTIVES

The aim of the current systematic review and meta-analysis is to determine clinical characteristics, causative microorganisms, treatment and prognosis of brain abscess in patients with hematological malignancies.

METHODS

Literature searches were performed on Medline, Embase, and CINAHL. Studies were included if they reported on five or more patients with a brain abscess and hematological malignancy and evaluated clinical characteristics, causative microorganisms, treatment modalities, or prognostic outcome measures of brain abscess. Study-level proportions were calculated per outcome and pooled using a random-effects meta-analysis of proportions with the Freeman-Tukey double arcsine transformation.

RESULTS

Nine studies including a total of 64 patients were retrieved. The mean age was 32 years and 29 of 42 patients (70%) were male. Aspergillus spp. were the most frequent causative microorganisms of the brain abscess and were found in 28 of 58 patients (50%). Neurosurgery was performed in 20 of 49 patients (40%) and medical treatment was administered in 43 of 44 patients (99%). Good outcome was achieved in 19 of 53 patients (37%), while 24 of 53 patients (45%) died.

CONCLUSION

In patients with hematological malignancies, brain abscesses are most caused by fungi. Despite intensive treatment, including neurosurgery and medical management, prognosis remains poor.