Introduction Brain abscess is an intra-parenchymal suppurative infectious condition of the brain caused by various microorganisms and potentially resulting in a life-threatening condition. Despite Thailand being located in a tropical region, studies on brain abscess are quite limited and outdated. Most of the published data in the Thai population were collected during a period when advanced neuroimaging techniques were not widely available. This issue contributed to late diagnosis and treatment that impacted the clinical outcomes. Therefore, our study aims to identify predictors of mortality among patients with brain abscess in Thailand.

Methods We retrospectively studied patients diagnosed with brain abscess admitted to Songklanagarind hospital in Songkhla, Thailand between 2002 and 2017. Demographic data, neurological status, clinical presentations, predisposing factors, microbiological profiles, neuroimaging findings, treatments, and outcomes were collected from electrical medical records. Predictors of death outcome were analysed by univariate and multivariate logistic regression analysis.

Results 81 patients were enrolled in the study. Forty-seven patients (58%) were male and 34 patients (42%) were female. The overall mean age was 47.68±16.92 years. The common risk factors of brain abscess were immunocompromised state (38.3%) and the extension of a peri-cranial infection (24.7%). The common clinical presentations were headache (61.7%), fever (50.6%), and hemiplegia (34.6%). Eleven patients (13.6%) were dead at hospital discharge. The independent factor associated with death outcome identified by multivariate analysis was confusion (odds ratio 7.67, 95% CI 1.95–30.14; p=0.003).

Conclusion The current study shows that increased immunocompromised state is a predisposing factor of brain abscess. The independent factor associated with death was confusion, which correlated with septic encephalopathy.