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Multiple brain abscesses in an extremely preterm infant and a 12-year follow up: a case report
Shulin Pan1, Su Lin1, Jing Lin2
1Department of Neonatology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
Insights
Extremely preterm infants with brain abscesses can achieve near-normal neurological function with early diagnosis and treatment. This case highlights potential neuroplasticity in extremely preterm infants following brain injury.
Area of Science:
- Neonatal neurology
- Pediatric neurosurgery
Background:
- Brain abscesses are rare but critical conditions in extremely preterm (EP) infants (GA < 28 weeks).
- Long-term follow-up data for EP infants with brain abscesses is scarce.
- Some cases show surprisingly intact neurological function post-injury.
Observation:
- A 27-week preterm infant with multiple brain abscesses was treated with surgical aspiration and antibiotics.
- Cranial MRI detected abscesses; follow-up MRI revealed encephalomalacia and periventricular leukomalacia.
- The patient experienced two seizure-like episodes at ages 8 and 11, with normal EEGs.
Findings:
- Despite brain injury, the patient exhibited no significant neurological deficits.
- Intellectual quotient (IQ) remained within the normal range during long-term follow-up.
- Electroencephalogram (EEG) results were normal despite seizure-like activity.
Implications:
- Early diagnosis and prompt treatment of brain abscesses in preterm infants can lead to improved outcomes.
- This case suggests significant neuroplasticity in the developing brains of extremely preterm infants.
- Effective management strategies can mitigate long-term neurological sequelae in this vulnerable population.
Background:
Brain abscesses are uncommon but life-threatening in extremely preterm (EP, Gestational Age < 28 weeks) infants. The information of long-time follow-up is rare, but very few cases presented almost intact neural function after injury.
Case Presentation:
We report the clinical course and the outcome of a 27-week preterm infant with multiple brain abscesses. The brain abscesses were detected by cranial magnetic resonance imaging (MRI) and were treated with surgical aspiration twice and a 7-week course of intravenous antibiotics. The patient had two episodes of seizure like activities at 8 and 11 years old respectively, whereas she had normal results of electroencephalogram (EEG). MRI showed encephalomalacia and periventricular leukomalacia. Otherwise, she had no obvious neurological deficits based on multiple physical examination and her intellectual quotient (IQ) was in normal range in the long-time follow-up.
Conclusions:
Early diagnosis of brain abscesses and appropriate therapy can improve the prognosis. Furthermore, this case report provides an example of the possible neuroplasticity of brain in EP infants.
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