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[Intracranial epidural abscess in a newborn secondary to skin catheter]
L M Fernández1, J Domínguez, A Callejón
1Servicio de Pediatría, Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife.
Insights
Intracranial epidural abscesses are rare in infants but can result from infected scalp vein catheters. Prompt diagnosis and surgical drainage with antibiotics led to a full recovery in a preterm infant.
Area of Science:
- Pediatric Neurosurgery
- Infectious Diseases
- Neonatal Care
Background:
- Intracranial epidural abscesses (IEAs) are uncommon, typically affecting older children and adults.
- IEAs often result from direct extension of adjacent infections.
- Focal neurological deficits are rare presenting symptoms.
Observation:
- A case report of an 11-day-old preterm infant with an IEA is presented.
- The abscess developed secondary to an infected scalp vein catheter.
- Diagnosis was confirmed using cranial ultrasound and CT scans.
Findings:
- Enterococcus faecium was identified as the causative pathogen.
- The infant underwent successful surgical drainage via right frontal craniotomy.
- A 2-week course of intravenous antibiotics was administered post-operatively.
Implications:
- Scalp vein catheters should be considered a potential cause of IEAs in neonates, especially preterm infants.
- Early diagnosis and intervention are crucial for favorable outcomes.
- This case highlights the importance of vigilance for catheter-related infections in neonates.
Abstract:
Intracranial epidural abscesses are uncommon lesions, being more frequents in older children and adults. They commonly arise as a result of direct extension of a preexisting infection and rarely present with focal deficit. We present a case of a 11-days old preterm infant who developed an intracranial epidural abscess as a result of an infected scalp vein catheter. The diagnosis was made on the basis of the cranial ultrasound and CT scan images. An identified strain of Enterococcus faecium was cultured from all the samples. The patient underwent a right frontal craniotomy with drainage of the abscess and a 2-week total course of intravenous antibiotics was administrated. CT scan imaging 3 week after the procedure demonstrated no evidence of residual lesion. When present, a scalp vein catheter, in absence of others predisponing factors, must be considered as an etiologic agent for an intracranial epidural abscess in this age-group.