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Nonsurgical management of neonatal multiple brain abscesses due to Proteus mirabilis
J A Hervás1, L Ciria, V Henales
1Department of Pediatrics, Virgen de Lluch Children's Hospital, Palma de Mallorca, Spain.
Abstract:
A newborn infant with Proteus mirabilis meningitis developed multiple brain abscesses with diameters ranging from 2 to 4 cm. Intravenous antibiotic therapy alone without surgical intervention led to the complete resolution of this complication. The case supports that this may be an acceptable treatment of multiple brain abscesses in neonates. However, the clinical outcome was relatively poor, since a porencephalic cyst, hypodense areas in CT scan, and psychomotor retardation were found at one year of age.
Insights
Intravenous antibiotics alone successfully treated multiple brain abscesses in a neonate with Proteus mirabilis meningitis. Despite resolution, the infant experienced long-term neurodevelopmental deficits, highlighting treatment efficacy versus developmental outcomes.
Area of Science:
- Neonatal neurology
- Infectious diseases
- Pediatric neurosurgery
Background:
- Neonatal meningitis caused by Proteus mirabilis can lead to severe intracranial complications.
- Brain abscesses in neonates pose significant management challenges, often requiring surgical intervention.
Observation:
- A newborn presented with Proteus mirabilis meningitis and subsequently developed multiple large brain abscesses (2-4 cm).
Findings:
- Complete resolution of brain abscesses was achieved with intravenous antibiotic therapy alone, without surgical drainage.
- Despite successful infection control, the infant exhibited poor neurodevelopmental outcomes at one year, including a porencephalic cyst and psychomotor retardation.
Implications:
- Non-surgical antibiotic management may be a viable option for multiple neonatal brain abscesses.
- Long-term neurodevelopmental monitoring is crucial for neonates treated for brain abscesses, even with successful radiological resolution.