ArticleBMC infectious diseases2026
Streptococcus anginosus group brain abscesses and subdural empyemas: exploratory compartment-specific phenotypes and discharge outcomes in a single-center retrospective cohort study.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIntracranial suppuration caused by the Streptococcus anginosus group (SAG) includes brain abscess and subdural empyema, but compartment-specific phenotypes and short-term outcomes remain incompletely described. We characterized clinical, radiological, and microbiological features and explored factors associated with poor discharge outcome.
methodsWe conducted a single-center retrospective cohort study of patients with imaging-confirmed intracranial suppuration and SAG identified by culture and/or metagenomic next-generation sequencing from October 2020 to October 2025. Cases were classified as intracerebral (n = 39), subdural (n = 6), or mixed (n = 7). The primary outcome was Glasgow Outcome Scale (GOS) at discharge; GOS 1-3 defined poor discharge outcome. Analyses were descriptive, with exploratory univariable logistic regression.
resultsA total of 52 patients were included. Patients with subdural empyema were younger and had numerically lower admission functional status than those with intracerebral infection, whereas subdural and mixed-compartment infections showed higher inflammatory-marker levels. Ventricular involvement was uncommon (5/52, 9.6%) and was observed more frequently among patients with poor discharge outcomes in unadjusted comparisons (5/12 vs. 0/40). Complete ring enhancement was confined to intracerebral cases, and S. intermedius was the predominant species. At discharge, 12 patients (23.1%) had poor outcomes, including six in-hospital deaths (11.5%). Lower admission KPS and fever were exploratory univariable associations with poor discharge outcome.
conclusionsThis study describes compartment-specific clinical, imaging, and microbiological features of Streptococcus anginosus group brain abscesses and subdural empyemas. Ventricular involvement may be a marker of severe disease, but all findings should be interpreted as exploratory and require validation in larger multicenter studies.
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