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Intracranial Mycobacterium abscessus infection in a healthy toddler

Julie S Martin1, David Zagzag, Maureen Egan

  • 1From the *Department of Pediatrics, Georgia Regents University/University of Georgia Health Sciences Campus, Athens, GA; †Department of Pathology; ‡Department of Neurosurgery; §Department of Pediatrics, New York University School of Medicine, New York, NY; ¶Department of Pediatric Radiology, Children's Hospital of Atlanta, Atlanta, GA; and ‖Saul Krugeman Division of Pediatric Infectious Diseases and Immunology, New York University School of Medicine, New York, NY.

The Pediatric Infectious Disease Journal
|August 22, 2014
PubMed

Insights

The first pediatric intracranial Mycobacterium abscessus infection in a child with neurofibromatosis type 1 was successfully treated. The regimen included surgery, steroids, and 16 weeks of antibiotics, leading to a full recovery.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Pediatrics

Background:

  • Neurofibromatosis type 1 (NF1) is a genetic disorder that can predispose individuals to various complications.
  • Intracranial infections are rare in pediatric patients, especially those caused by non-tuberculous mycobacteria.
  • Mycobacterium abscessus is an emerging opportunistic pathogen known for its resistance to antibiotics.

Observation:

  • A 16-month-old female with a history of neurofibromatosis type 1 presented with symptoms suggestive of an intracranial infection.
  • Diagnostic imaging revealed an intracranial abscess.
  • Cerebrospinal fluid analysis confirmed the presence of Mycobacterium abscessus.

Findings:

  • The patient underwent an excisional biopsy of the abscess.
  • A treatment regimen comprising high-dose steroids and 16 weeks of triple antimicrobial therapy was initiated.
  • The patient achieved clinical cure with no evidence of residual infection.

Implications:

  • This case highlights the importance of considering rare pathogens in immunocompromised pediatric patients.
  • The successful treatment strategy provides a potential therapeutic approach for similar future cases.
  • Early diagnosis and aggressive management are crucial for favorable neurologic outcomes in pediatric intracranial mycobacterial infections.

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