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Published on: February 9, 2011
Brain Abscess Associated with Polymicrobial Infection after Intraoral Laceration: A Pediatric Case Report
Fumihiro Ochi1, Hisamichi Tauchi1, Toyohisa Miyata1
1Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Insights
A rare polymicrobial brain abscess in a child with congenital cyanotic heart disease (CCHD) was successfully treated. Prompt cranial imaging is crucial for early diagnosis in at-risk pediatric patients with neurological changes.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Brain abscesses are serious infections, but polymicrobial cases are uncommon in children.
- Congenital cyanotic heart disease (CCHD) can increase the risk of brain abscesses.
Observation:
- A 9-year-old girl with CCHD presented with right hemiplegia following an oropharyngeal injury.
- Diagnosis was challenging due to nonspecific symptoms.
Findings:
- The patient was diagnosed with a brain abscess caused by *Streptococcus intermedius*, *Parvimonas micra*, and *Fusobacterium nucleatum*.
- Treatment included intravenous antibiotics, surgical drainage, and antiedema therapy.
- Neurological deficits resolved, and the patient was discharged after eight weeks of therapy.
Implications:
- This case underscores the importance of early cranial imaging in pediatric patients with CCHD and neurological symptoms.
- Prompt diagnosis and treatment are vital for favorable outcomes in pediatric brain abscesses.
- Highlights the potential for polymicrobial brain abscesses in children with specific risk factors.
Abstract:
Brain abscesses, infections within the brain parenchyma, can arise as complications of various conditions including infections, trauma, and surgery. However, brain abscesses due to polymicrobial organisms have rarely been reported in children. We herein report a case of a 9-year-old girl with unresolved congenital cyanotic heart disease (CCHD) presenting with right hemiplegia who was diagnosed with brain abscess caused by Streptococcus intermedius, Parvimonas micra, and Fusobacterium nucleatum after oropharyngeal injury. She was treated with intravenous antimicrobial therapy, drainage under craniotomy, and antiedema therapy with glycerol and goreisan, which led to the improvement of right hemiplegia to baseline; she was discharged following eight weeks of intravenous antimicrobial therapy. The clinical diagnosis of the brain abscess was difficult due to the nonspecific presentation, highlighting the importance of cranial imaging without haste in patients at increased risk for brain abscesses such as those with CCHD, presenting with fever in the absence of localizing symptoms or fever, accompanied with abnormal neurological findings.
