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Brain abscesses and ischemic necrotic lesions during early childhood
1Department of Neurosurgery, University of Lisbon, Portugal.
Insights
Seven infants under six months experienced cerebral abscesses, often linked to meningitis or mass lesions. Proteus was the most common pathogen, with multiple ischemic necrosis areas observed in most cases.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroimaging
Background:
- Cerebral abscesses are rare in infants under six months.
- Previous meningitis or expanding mass lesions are common precursors.
Observation:
- Seven cases of cerebral abscesses in infants under six months are presented.
- Infectious agents included Proteus (4 cases), E. coli (1 case), and Citrobacter (1 case); one case was culture-negative.
- Six children exhibited multiple areas of ischemic necrosis, sometimes contralateral to the abscess.
Findings:
- Proteus species were the predominant causative agent.
- Cerebral abscesses in this age group frequently involve ischemic necrosis.
- Contralateral ischemic necrosis suggests complex pathophysiological mechanisms.
Implications:
- Highlights the unique clinical and diagnostic challenges of infant cerebral abscesses.
- Emphasizes the need for early recognition and tailored therapeutic strategies.
- Suggests potential for advanced neuroimaging to guide diagnosis and management.
Abstract:
The cases of seven children, all under 6 months of age, with cerebral abscesses are presented. In four cases, there was previous meningitis; the others presented with expanding mass lesions. The infectious agent was Proteus in four cases and Escherichia coli and Citrobacter in one each; in another patient, no agent was isolated. In six children, there were multiple areas of ischemic necrosis. In one instance, these areas were in the hemisphere contralateral to the purulent collection. The peculiar clinical, diagnostic, and therapeutic aspects of brain abscesses in this age group are discussed.