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Updated: Mar 30, 2026

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Neonatal brain abscess: An atypical presentation
Rupesh Masand1, Ahmad Ali1, Alok Purohit1
1Department of Paediatrics, NIMS Medical College, Jaipur, Rajasthan, India.
Abstract:
Brain abscesses occur as an uncommon complication of bacterial meningitis in the neonatal period. A 34 weeks preterm at-risk neonate presented with abnormal breathing pattern and inability to maintain the oxygen saturation in room air. Magnetic resonance imaging (MRI) study revealed intra-parenchymal brain abscesses in the left basal ganglion and bilateral fronto-parietal regions. Intravenous piperacillin - tazobactam was commenced and continued for 6 weeks in Neonatal Intensive Care Unit. No surgical intervention was required. The patient responded to the medical management and was discharged after the documentation of radiological clearance in repeat MRI study. No complications were recorded. An appropriate neuro-developmental outcome was observed on follow-up. Brain abscesses may not be preceded by meningitis in all neonates. A strong clinical suspicion is required for the diagnosis especially in cases with atypical presentation.
Insights
Neonatal brain abscesses, a rare complication, can occur without meningitis. This case highlights successful antibiotic treatment in a preterm infant with atypical presentation, showing good neurodevelopmental outcomes.
Area of Science:
- Neonatal neurology
- Pediatric infectious diseases
- Neuroimaging
Background:
- Brain abscesses are uncommon in neonates, often linked to bacterial meningitis.
- Early diagnosis and management are crucial for favorable outcomes.
Observation:
- A 34-week preterm infant presented with respiratory distress and hypoxia.
- Magnetic resonance imaging (MRI) revealed intra-parenchymal brain abscesses.
Findings:
- Successful treatment with intravenous piperacillin-tazobactam for 6 weeks.
- No surgical intervention was needed; radiological clearance achieved.
- The infant showed appropriate neurodevelopmental progress post-discharge.
Implications:
- Brain abscesses in neonates may not always follow meningitis.
- Clinical suspicion is vital for diagnosing atypical presentations.
- Antibiotic therapy can be effective, avoiding surgery in select cases.
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