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Brain abscess following delayed endoscopic removal of an initially asymptomatic esophageal coin
J P Louie1, K C Osterhoudt, C W Christian
1Division of Pediatric Emergency Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine 19104, USA. louiej@email.chop.edu
Insights
A rare pediatric brain abscess case followed esophageal foreign body removal. This suggests a potential link between delayed coin extraction and intracranial infection, warranting further study.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Gastroenterology
Background:
- Brain abscesses are uncommon in children, often linked to ear, nose, throat infections or congenital heart disease.
- Diagnosis can be challenging due to the rarity and varied presentations.
Observation:
- A 13-month-old child developed a brain abscess two weeks after undergoing rigid endoscopy.
- The procedure was for the removal of an esophageal coin that had been asymptomatic for weeks.
Findings:
- This case represents the first reported instance of a brain abscess following endoscopic removal of an esophageal foreign body.
- The findings suggest a possible association between prolonged presence of esophageal foreign bodies and subsequent intracranial infection.
Implications:
- This case highlights a potential, previously unrecognized risk factor for pediatric brain abscesses.
- Further investigation into the association between delayed esophageal foreign body extraction and intracranial infections is recommended.
Abstract:
Brain abscesses are rare occurrences in pediatric patients, and making their diagnosis can be difficult. The two most commonly cited risk factors are otorhinologic infections and cyanotic congenital heart disease (CCHD). We present a 13-month-old child with a brain abscess who, 2 weeks prior, underwent rigid endoscopy for the extraction of a coin from the esophagus. We believe this to be the first such report of a brain abscess after rigid endoscopy for removal of an esophageal foreign body. In this case the esophageal coin was initially asymptomatic and had been present for weeks prior to removal. The potential association between delayed coin extraction and development of an intracranial infection, suggested by this report, may warrant investigation.