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[Cerebral abscess secondary to esophageal dilatations]
E López-Candel1, J Castejón Casado, C Sánchez López-Tello
1Servicio de Cirugía Pediátrica, H. G. E. Virgen de las Nieves, Granada.
Insights
Esophageal dilation in children with caustic stenosis can lead to cerebral abscess. Early suspicion based on fever and neurological signs, confirmed by CT scans, is crucial for prompt treatment and favorable outcomes.
Area of Science:
- Pediatric Neurology
- Gastroenterology
- Infectious Diseases
Background:
- Caustic esophageal stenosis often requires esophageal dilation procedures in pediatric patients.
- Esophageal dilation carries a risk of complications, including infectious pathways to the central nervous system.
Observation:
- Two pediatric cases presented with cerebral abscess following esophageal dilation for caustic stenosis.
- Clinical presentation included high fever and neurological deficits post-dilation.
Findings:
- Cranial computed tomography (CT) confirmed the diagnosis of cerebral abscess in both patients.
- Treatment varied, with one patient receiving antibiotics and the other undergoing surgical drainage and antibiotics.
- Both patients experienced favorable clinical courses.
Implications:
- Highlights the importance of suspecting cerebral abscess in pediatric patients undergoing esophageal dilation, especially with fever and neurological changes.
- Emphasizes the role of clinical suspicion and cranial CT in early diagnosis.
- Discusses potential pathogenic routes for bacterial dissemination from the esophagus to the brain.
Abstract:
We report two cases of cerebral abscess secondary to esophageal dilations in children with caustic stenosis of the esophagus. High fever and neurological findings postdilation lead us to suspect this complication. Cranial C.T. confirmed the diagnosis. Clinical course was favourable in both patients, with antibioterapy on the first case and combined therapy with surgical drainage and parenteral antibiotics on the second patient. We remark the importance of suspect this complication on the basis of clinical and tomographic findings on the pediatric patients subjected to esophageal dilations. Pathogenic ways of bacterial dissemination from the esophagus to the brain are discussed and reviewed.