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Brain abscess in infants
1Salahuddin University Hospital, Tripoli, Libya.
Insights
Infant brain abscesses, often caused by meningitis or sepsis and frequently involving Gram-negative bacteria, present unique challenges. Early diagnosis and intervention are crucial, as large or multiple abscesses are associated with a poor prognosis.
Area of Science:
- Pediatrics
- Neurology
- Infectious Diseases
Background:
- Brain abscesses are uncommon in infants, presenting with distinct clinical features specific to this demographic.
- Seven infant cases (2-11 months) are analyzed, highlighting underlying causes and causative agents.
Purpose of the Study:
- To describe the clinical presentation, management, and outcomes of brain abscesses in infants.
- To emphasize the importance of early diagnosis and monitoring in at-risk infants.
Main Methods:
- Retrospective case series analysis of seven infants diagnosed with brain abscess.
- Review of clinical data, including etiology, causative organisms, abscess characteristics, treatment modalities, and patient outcomes.
Main Results:
- Meningitis (4/7) and sepsis (2/7) were the primary underlying conditions. Gram-negative organisms were identified in 6/7 patients.
- Five abscesses measured ≥5 cm, and four cases involved multiple lesions. Management included aspiration, irrigation, drainage, and one craniotomy.
- Mortality occurred in two infants. Of four with follow-up, only one showed a good outcome.
Conclusions:
- Early diagnosis of infant brain abscess is critical, necessitating close ultrasound or CT monitoring in infants with bacterial meningitis and sepsis.
- The prognosis for infants with large or multiple brain abscesses is generally poor, underscoring the need for timely and effective intervention.
Abstract:
Brain abscesses are rare in infants and their clinical presentation is specific for this age group. Seven cases of brain abscess in infants aged 2-11 months are reported. The underlying cause was meningitis in four, sepsis in two, and unknown in one. Gram-negative organisms were cultured in 6 patients. The abscess size was 5 cm or more in five cases; in four there were multiple lesions. Two abscesses were aspirated and irrigated; four particularly large lesions were drained and repeatedly aspirated and irrigated. One craniotomy was done. There were two deaths, one in the postoperative period and the other 6 months after discharge. Follow-up information is available for four children, showing a good result in only one of them. Formation of an abscess should be diagnosed early, and close ultrasound monitoring or CT scanning in infants with bacterial meningitis and sepsis is essential. The prognosis in cases in which large/multiple abscesses develop is poor.