Neonatal brain abscess: An atypical presentation

Rupesh Masand1, Ahmad Ali1, Alok Purohit1

  • 1Department of Paediatrics, NIMS Medical College, Jaipur, Rajasthan, India.

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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