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.