Background: Brain abscess (BA) is a focus of parenchymal suppuration which is rare, but a serious infection. In children, congenital heart disease (CHD) was the main predisposing factor of BA in developed countries in the past. The aim of this study was to identify predisposing factors, etiological causes and outcome of BA in our institution.

Methods: In a retrospective study, records of 200 patients with diagnosis of BA, who were admitted in Nemazee Hospital, Shiraz University, Iran, between 1996-2006, the clinical and paraclinical work ups were reviewed. The data are presented as percentile with mean ± SD.

Results: The age range was 5 days to 76 years (mean 23.95 ± 18.18 years), male to female ratio of 1.3 and 106 (53%) patients were below 18 years. Common signs and symptoms were: headache 56.5%, vomiting 55% and fever 51.5%. About 78% presented with a known predisposing factor. In children, cyanotic CHD was the main factor 20.7%, while in adult population only 11.7% had CHD. The most frequently encountered pathogens were gram positive organisms 48.3% and the gram negatives 37%. Computed tomography (CT) and magnetic resonance imaging (MRI) were used for diagnosis in 71% and 14.5% of patients respectively. Overall favorable outcome noticed in 68.5% with 19% mortality in our study population.

Conclusion: While nowadays there has been much improvement in diagnostic modalities, bacteriological studies, new antibiotics and better surgical management of BA, in developing countries, CHD which may be correctable surgically, are still the most common predisposing factor for BA.