Brain abscess – a rare but a serious infection in childhood

Česká verzia

Authors: E. Dická ¹; Ľ. Podracká ¹; Z. Pavlovičová ²; I. Vojtech ³
Authors place of work: Detská klinika DFNsP a LFUK, Bratislava ¹; Rádiologicko-diagnostické oddelenie DFNsP, Bratislava ²; KIGM, Univerzitná nemocnica, Bratislava ³
Published in the journal: Čes-slov Pediat 2017; 72 (8): 489-494.
Category: Case Report

Summary

Neuroinfections are among the most urgent medical conditions. A brain abscess may have been maturing for weeks or even months. The clinical symptoms are nonspecific and may include fever, up to a consciousness disorder when the abscess spills over into ventricles of the brain. CT and MRI scans of the brain are a key to a correct diagnosis. Lumbar puncture may not give relevant information. Treatment must be aggressive and depends on the size and site of the abscess. The general recommendation is an evacuation of the brain abscess and a minimum administration of 6 to 8 weeks of intravenous antibiotics with good penetration through the hematoencephalic barrier.

The autors present three interesting cases of children with brain abscesses. Pre-disposition factors were present in all three patients (two had the cyanotic heart defect and one had esophageal varices) and the patients had surgeries without relevant antibiotic prophylaxis in their pre-disease period. Streptococcus was cultivated in two patients and the infectious agent was not identified in the boy patient with multiple abscesses. Abscess evacuation combined with wide-spectrum antibiotics resulted in healing of two children but the patient with multifocal abscesses died in spite of the aggressive therapy.

Key words:
brain abscess, CT and MRI scan of brain, brain abcess treatment

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