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Infections
1Department of Pediatric Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.
Insights
Pediatric central nervous system (CNS) infections present unique challenges due to differing immune responses and limited clinical data in children. This review details common, rare, and mimic infections, imaging strategies, and risks associated with anesthesia and contrast agents.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroradiology
Background:
- Pediatric central nervous system (CNS) infections differ significantly from adult infections due to unique immune responses and diagnostic challenges.
- Clinical presentation can be obscured by limited patient history and information.
- Global travel and antimicrobial resistance increase the likelihood of encountering unusual or resistant CNS pathogens in children.
Purpose of the Study:
- To outline the natural history and clinical presentation of various pediatric CNS infections.
- To guide the selection of appropriate imaging modalities for diagnosing CNS infections in children.
- To discuss challenges in pediatric CNS infection imaging, including radiation safety, anesthesia, and contrast agent use.
Main Methods:
- Review of common, rare, and mimic CNS infections in pediatric populations.
- Discussion of diagnostic imaging techniques and their applications.
- Analysis of challenges and safety considerations in pediatric neuroimaging.
Main Results:
- Illustrative examples of common and rare pediatric CNS infections and their complications are presented.
- Guidance on preferred imaging modalities based on infection type and clinical context is provided.
- Strategies for minimizing radiation exposure and addressing concerns regarding anesthetic and contrast agents are discussed.
Conclusions:
- Pediatric CNS infections require specialized diagnostic and management approaches distinct from adults.
- Appropriate imaging selection and safety protocols are crucial for effective diagnosis and treatment.
- Increased global travel and drug resistance necessitate heightened awareness of diverse and potentially resistant CNS pathogens in children.
Abstract:
"Children are not little adults," and while this is a well-worn aphorism, it is especially true in the context of infection, where the same organism may evoke a different immune response in the pediatric central nervous system (CNS) and clinical presentation may be clouded by the lack of a good history or paucity of clinical information. The chronology and natural history of different organisms/infections will be laid out together with the preferred use of different imaging modalities. This chapter will use illustrative examples of some of the more common infections and their complications, in addition to several more rare conditions as well as mimics of childhood CNS infection. Challenges in the imaging of children, including strategies to minimize the use of radiation, are discussed. Some of the more recently voiced concerns regarding the use of anesthetic agents in children are also addressed, along with the contrast agents that are typically required for imaging. With a global increase in worldwide travel the anticipation is that pediatricians will increasingly see unusual organisms presenting with CNS infection while dealing with the ever-present risk of drug resistance with inappropriately treated common or garden infections.
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