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Brain abscesses in children with cancer
N L Antunes1, S Hariharan, L M DeAngelis
1Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. AntunesN@mskcc.org
Medical and Pediatric Oncology
|June 2, 1998
Summary
Pediatric brain abscesses are rare but serious in children with cancer, often caused by fungi. High mortality necessitates prompt diagnosis and treatment, including surgical drainage and antifungal therapy.
Area of Science:
- Pediatric Neurology
- Pediatric Oncology
- Infectious Diseases
Background:
- Brain abscesses are rare in children, with varying causes and outcomes.
- Children with cancer are at increased risk due to immune system changes from cancer and treatment.
- This study focuses on pediatric cancer patients who developed brain abscesses during malignancy treatment.
Purpose of the Study:
- To define the clinical characteristics of brain abscesses in pediatric cancer patients.
- To determine the prognosis and optimal management strategies for these patients.
- To identify common and rare causative organisms in this patient population.
Main Methods:
- A retrospective review of medical records was conducted.
- The study included pediatric cancer patients (<20 years) diagnosed with brain abscess between 1980 and 1996.
- Clinical and laboratory data were analyzed.
Main Results:
- Twelve pediatric cancer patients with brain abscesses were identified.
- Leukemia was the most common cancer diagnosis (8 patients), followed by brain tumors and PNET.
- Fungal infections (Aspergillus, Fusarium, Candida) were prevalent, with a 42% mortality rate.
Conclusions:
- High mortality in this immunosuppressed group is linked to a high rate of fungal infections.
- Surgical drainage and culture are crucial for identifying rare pathogens.
- Empiric antibiotic therapy, including antifungals, may be effective in some cases.