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Brain abscess – a rare but a serious infection in childhood


Authors: E. Dická 1;  Ľ. Podracká 1;  Z. Pavlovičová 2;  I. Vojtech 3
Authors‘ workplace: Detská klinika DFNsP a LFUK, Bratislava 1;  Rádiologicko-diagnostické oddelenie DFNsP, Bratislava 2;  KIGM, Univerzitná nemocnica, Bratislava 3
Published in: Čes-slov Pediat 2017; 72 (8): 489-494.
Category: Case Report

Overview

Neuroinfections are among the most urgent medical conditions. A brain abscess may have been maturing for weeks or even months. The clinical symptoms are nonspecific and may include fever, up to a consciousness disorder when the abscess spills over into ventricles of the brain. CT and MRI scans of the brain are a key to a correct diagnosis. Lumbar puncture may not give relevant information. Treatment must be aggressive and depends on the size and site of the abscess. The general recommendation is an evacuation of the brain abscess and a minimum administration of 6 to 8 weeks of intravenous antibiotics with good penetration through the hematoencephalic barrier.

The autors present three interesting cases of children with brain abscesses. Pre-disposition factors were present in all three patients (two had the cyanotic heart defect and one had esophageal varices) and the patients had surgeries without relevant antibiotic prophylaxis in their pre-disease period. Streptococcus was cultivated in two patients and the infectious agent was not identified in the boy patient with multiple abscesses. Abscess evacuation combined with wide-spectrum antibiotics resulted in healing of two children but the patient with multifocal abscesses died in spite of the aggressive therapy.

Key words:
brain abscess, CT and MRI scan of brain, brain abcess treatment


Sources

1. Frazier JL, et al. Management of brain abscesses in children. Neurosurg Focus 2008; 24 (6): E8.

2. Muzumdar D, et al. Brain abscess: An overview. Int J Surg 2011; 9: 136–144.

3. Atiq M, Ahmed US, Alliana SS, Christi KN. Brain abscess in children. Indian J Pediatr 2006; 73 (5): 401–404.

4. Sengul G, Tuzun Y, Zengin S, Ozden K. Pediatric intracerebral abscess: review of 43 surgically treated cases. J Neurol Sci 2014; 31 (1): 136–143.

5. Vojtech I. Aktuálne trendy v diagnostike a liečbe purulentných ventrikulitíd u neurochirurgických pacientov [špecializačná práca]. Bratislava: SZU, 2009: 52.

6. Goldenberg Z. Akútne infekcie centrálneho nervového systému. Neurologie pro praxi 2002/6: 305–307.

7. Shachor-Meyouha Y, et al. Brain abscess in children – epidemiology, predisposing factors and management in the modern medicine era. Acta Pædiatrica 2010; 99: 1163–1167.

8. Kai-Liang K, Keh-Gong W, Chun-Jen Ch, et al. Brain abscess in children: analysis of 20 cases presenting at a medical center. J Microbiol Immunol Infect 2008; 41: 403–407.

9. Wong TT, Lee LS, Wang HS, et al. Brain abscesses in children a cooperative study of 83 cases. Child Nerv Syst 1989; 5: 19–24.

10. Soutwick FS. Treatment and prognosis of bacterial brain abscess. http://www.uptodate.com/contents/treatment-and-prognosis-of-bacterial-brain-abscess.

11. Sengul G, Tuzun Y, Zengin S, Ozden K. Pediatric intracerebral abscess: review of 43 surgically treated cases. J Neurol Sci 2014; 31 (1): 136–143.

12. Seydoux C, Francioli P. Bacterial brain abscesses: factors influencing mortality and sequelae. Clin Infect Dis 1992; 15: 394.

13. Brouwer MC, et al. Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology 2014; 82: 806.

14. Rau CS, Chang WN, Lin YC, et al. Brain abscess caused by aerobic gram-negative bacilli: clinical features and therapeutic outcomes. Clin Neurol Neurosurg 2002; 105: 60.

15. Tattevin P, Bruneel F, Clair B, et al. Bacterial brain abscesses: a retrospective study of 94 patients admitted to an intensive care unit (1980 to 1999). Am J Med 2003; 115: 143.

16. Moorthy RK, Rajshekhar V. Management of brain abscess: an overview. Neurosurg Focus 2008; 24: E3.

17. Prusty GK. Brain abscesses in cyanotic heart disease. Indian J Pediatr 1993; 60: 43–53.

18. Jati A, Venkatesh SK, Patel K, Malik S. Diffusion MR imaging for cerebral abscess. Neurol India 2004 Dec; 52 (4): 505–507.

19. Kamra P, Vatsal DK, Husain M, et al. MRI demonstration of unsuspected intraventricular rupture of pyogenic cerebral abscesses in patients being treated for meningitis. Neuroradiology 2002; 44: 114.

20. Al Masalma M, Lonjon M, Richet H, et al. Metagenomic analysis of brain abscesses identifies specific bacterial associations. Clin Infect Dis 2012; 54: 202.

21. Brook I. Brain abscess. http://reference.medscape.com/article/212946-overview.

Labels
Neonatology Paediatrics General practitioner for children and adolescents
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