Clinical characteristics, management and outcomes of intracranial suppurative infections in southern Mozambique: a three-year retrospective study

Background Intracranial suppurative infections (ISIs) are life-threatening conditions associated with significant morbidity and mortality, particularly in low- and middle-income countries where delays in diagnosis and limited access to specialized care are common. Data on the clinical and surgical profile of ISIs in sub-Saharan Africa remain scarce. Methods We conducted a retrospective cross-sectional study including patients who were diagnosed with brain abscess or intracranial empyema and admitted to a quaternary referral hospital in southern Mozambique between January 2021 and December 2023. As a quaternary-level referral center and national reference hospital for southern Mozambique, Maputo Central Hospital was selected as the study site because of its high volume of neurosurgical cases. Demographic, clinical, radiological, treatment and outcome data were analysed via SPSS v21. Results Most patients were male (71.4%), with a mean age of 16.97 ± 8.4 years. The most common presenting symptom was seizures (24.3%), and paranasal sinusitis was the leading risk factor (58.6%). Subdural empyema (62.9%) and convexity localization (55.7%) were the predominant imaging findings. Craniotomy was performed in 87.1% of the patients. Overall, 95.8% of patients were discharged and were clinically stable, while the mortality rate was 4.3%. Conclusion Intracranial supurative infections predominantly affect pediatric male patients in southern Mozambique. Despite delayed presentation and limited resources, favourable outcomes are achieved through timely medical and surgical management. These findings highlight the importance of early recognition, appropriate referral and multidisciplinary care for intracranial suppurative infections in low-resource settings.