Korean J Pediatr Infect Dis.  2008 May;15(1):29-34. 10.14776/kjpid.2008.15.1.29.

Clinical Features of Brain Abscesses in Neonates and Children: A Single Center Experience from 1997 to 2006

• Lee TJ
• Chun JK
• Kim KH
• Kim KJ
• Kim DS

• KMID: 2439939
• DOI: http://doi.org/10.14776/kjpid.2008.15.1.29

Abstract

PURPOSE
We evaluated clinical presentations of brain abscesses, including predisposing factors, causative organisms, and mortality rate in neonates and children.
METHODS
We retrospectively reviewed the medical charts of neonates and children with brain abscesses treated at Severance Hospital from January 1997 through December 2006.
RESULTS
Among 27 neonates and children with brain abscesses, overall mortality was 22% and 38% of survivors developed neurologic sequelae. The mortality rate was 38% in 8 infants with brain abscesses. The most common location of brain abscesses were frontal and parietal lobes, followed by temporal lobe. There were 7 cases with multiple brain abscesses. Streptococci (33%), Staphylococci (27%), and Gram-negative enterics (20%) were commonly isolated. The common predisposing conditions were neurosurgical procedure (30%), cyanotic congenital heart disease (15%), and sinusitis/otitis (7%). Fever (74%), headache (37%), nausea/vomiting (33%), and altered mental status (33%) occurred commonly. Compared with children older than 1 year of age, infants were associated with multiple brain abscesses (63%, P=0.011) and high rates of death or neurologic sequelae (88%, P=0.033).
CONCLUSION
We should have a high index of suspicion in order to recognize the condition as early as possible, especially in infancy with brain abscesses who presents vague or nonspecific symptoms and signs.

Keyword

Brain abscess; Neurosurgery; Infant; Children

MeSH Terms

Brain Abscess*
Brain*
Causality
Child*
Fever
Headache
Heart Defects, Congenital
Humans
Infant
Infant, Newborn*
Mortality
Neurosurgery
Neurosurgical Procedures
Parietal Lobe
Retrospective Studies
Survivors
Temporal Lobe