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Intracranial suppuration.

Nicole Leotta1, Ray Chaseling, Glen Duncan

  • 1Department of Allergy, Immunology and Infectious Diseases, Children's Hospital at Westmead, New South Wales, Australia.

Journal of Paediatrics and Child Health
|September 10, 2005
PubMed
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This study evaluated children with subdural empyema (SDE) and brain abscess (BA), finding that while mortality is low, neurological complications remain high. Early diagnosis and treatment of these pediatric intracranial infections are crucial.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Intracranial suppuration, including subdural empyema (SDE) and brain abscess (BA), is a serious condition in children.
  • Understanding the specific characteristics and outcomes of SDE and BA is vital for effective management.

Purpose of the Study:

  • To determine the prevalence, age distribution, predisposing factors, bacteriology, clinical features, and outcomes of pediatric SDE and BA.
  • To identify differences in presentation and outcomes between SDE and BA in children.

Main Methods:

  • A retrospective hospital-based study was conducted.
  • Clinical data of children diagnosed with SDE or BA over 10.75 years at a tertiary children's hospital were reviewed.

Main Results:

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  • Forty-six children with intracranial suppuration were identified (26 BA, 16 SDE, 4 both).
  • Sinusitis was a predisposing factor for SDE; Streptococcus milleri was common in SDE. Periorbital edema and photophobia were associated with SDE.
  • Mortality was low (3/46), but neurological complications were high (54.3%), more frequent in BA. Outcomes varied by age, with peaks for SDE at <2 and >7 years, and for BA at 9-11 years.

Conclusions:

  • Intracranial suppuration in children has a low mortality rate but high morbidity.
  • Prompt diagnosis and treatment are essential to improve outcomes and reduce neurological deficits.