Brain abscess is rather uncommon, accounting for 1 in 10,000 hospitalizations. This incidence is much less than that of bacterial meningitis and is only 2 percent that of brain tumors. The rate has gradually fallen over the past century, probably reflecting the effect of antibiotics on predisposing conditions, such as otitis media. Mortality rates for diagnosed cases have also fallen, from about 50 percent in the early twentieth century to a current level of 10 to 20 percent. Long-term sequelae are seen in about a third of survivors.
Age distribution corresponds to the various predisposing conditions. Most patients with brain abscess related to a paranasal sinus focus are in the 10- to 30-year-old range. When the source is otic, a bimodal incidence occurs in ages less than 20 and greater than 40 years. Twenty-five percent of cases occur in children under 15 years old, with the majority occuring in the 4- to 7-year-old range. Pockets of higher incidence occur along the lines of age, origin of initial infection, and, in some cases, gender.
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