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A case series of brain abscesses in Malawian children

L Mankhambo1, A Phiri, K Chiwaya

  • 1Department of Paediatrics and MLW Clinical Research Programme, Blantyre, Malawi.

Malawi Medical Journal : the Journal of Medical Association of Malawi
|July 24, 2013
PubMed

Insights

Diagnosing brain abscesses in children is challenging in resource-poor settings due to similar symptoms with cerebral malaria and meningitis. Cranial CT scans are vital for accurate diagnosis and management of pediatric brain abscesses.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Brain abscesses in children present diagnostic challenges, especially in resource-limited settings.
  • Common central nervous system infections in Malawi mimic brain abscess symptoms, potentially leading to underdiagnosis.
  • HIV-uninfected children in Malawi were studied to understand brain abscess presentation.

Purpose of the Study:

  • To report cases of pediatric brain abscess in a resource-poor setting.
  • To highlight diagnostic and management difficulties of brain abscess in children.
  • To emphasize the utility of cranial CT scans in diagnosing pediatric brain abscess.

Main Methods:

  • Retrospective case series of three children admitted with brain abscess.
  • Clinical data review including presenting symptoms, extracranial sources of infection, and diagnostic procedures.
  • Review of diagnostic imaging, specifically cranial CT scans.

Main Results:

  • Three HIV-uninfected children presented with brain abscesses.
  • Identified associated conditions included staphylococcal empyema and chronic suppurative otitis media/mastoiditis; one case had no identified extracranial focus.
  • Clinical presentations overlapped with cerebral malaria and meningitis, complicating diagnosis.

Conclusions:

  • Brain abscess diagnosis and management in resource-poor settings are complex due to overlapping symptomatology with other CNS infections.
  • Pediatric brain abscesses may be frequently underdiagnosed in regions like Malawi.
  • Cranial CT scans are crucial for the accurate diagnosis and effective management of pediatric brain abscesses.

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