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Wu X, Qin N, Peng X, Wang L. Exploring odontogenic brain abscesses: a comprehensive review. Acta Neurol Belg 2024; 124:1155-1165. [PMID: 38722527 DOI: 10.1007/s13760-024-02569-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/29/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Whether in neurology or dentistry, odontogenic brain abscess stands as an ailment demanding undivided attention. The onset of this disease is insidious, with a relatively low incidence rate but a markedly high fatality rate. Moreover, its symptoms lack specificity, easily leading to misdiagnosis, oversight, and treatment delays. Hence, clinicians should maintain heightened vigilance when faced with pathogenic bacteria of dental origin in patients. AREAS COVERED This paper encapsulates the latest research findings on the clinical manifestations and essential treatment points of odontogenic brain abscess. It may offer a crucial reference for prompt diagnosis and improved therapeutic approaches. EXPERT OPINIONS Odontogenic brain abscess, an infection of the cerebral parenchyma, usually appears in immunocompromised patients with dental ailments or postdental surgeries. The main pathogenic microorganisms include Streptococcus intermedius, Fusobacterium nucleatum, Streptococcus anginosus, and Millerella. Given the undetectable and nonspecific symptoms in patients, the diagnostic process relies on microbiological methods. Therefore, clinicians should actively investigate and identify the pathogenic microorganisms of odontogenic brain abscess for early detection and selection of appropriate treatment regimens to avoid disease management delays.
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Affiliation(s)
- Xingguo Wu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ningxiang Qin
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xi Peng
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Liang Wang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Mohammad R, Maoldomhnaigh CÓ, Crimmins D. Clinical characteristics and outcomes of children with non-sinogenic Brain infections. Br J Neurosurg 2023:1-9. [PMID: 38149672 DOI: 10.1080/02688697.2023.2297877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/16/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Central Nervous System (CNS) suppurative infections are serious but rare conditions in the paediatric population. Data on long-term neurocognitive and quality of life outcomes in children recovering from these infections are lacking. METHODS A retrospective cohort review of children <16 years with non-sinogenic infections undergoing neurosurgery was conducted. Data for patients admitted to Children's Health Ireland at Temple St between 2008-2021 were analysed for clinical and microbiological profiles. Follow-up reviews evaluating neurological and academic sequelae and quality of life were performed. Categorical variables were analysed for unfavourable outcome with a p < 0.05 significance value. RESULTS Forty patients were included with a mean age of 4.5 years and equal gender distribution. Fever (68%) and vomiting (58%) were the most common presenting complaints. Only fourteen (35%) patients presented with the classic triad of fever, headache, and focal neurological deficit. Meningitis/Encephalitis was the most common cause of suppurative infection (40%). Predisposing factors included congenital heart disease (18%), prematurity (15%) and immunocompromised status (10%). More patients received an initial Burr hole aspiration (73%) than Craniotomy (27%). The re-operation rate was higher in the craniotomy group (45%) compared to the burr hole group (34%), but this was not statistically significant (p = 0.522). Four patients died (10%) including two intra-hospital deaths (5%). Male gender (p = 0.047) and multiple abscesses (p = 0.041) were associated with unfavourable outcome at discharge. Mobility impairment was the most affected determinant of quality of life. CONCLUSION CNS suppurative infections are associated with long-term neurocognitive sequelae in children. Multiple abscesses and male gender are associated with unfavourable GOS on discharge. Children are still left with mobility impairment (25%), personality changes (23%) and intellectual disability (18%) at an average of 5 years. Long-term follow up with multidisciplinary input is required. Further research should focus on evaluating long-term HRQoL in children.
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Affiliation(s)
- Retaj Mohammad
- Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland
- Department of Neurosurgery, Temple St Children's University Hospital, Ireland
| | - Cilian Ó Maoldomhnaigh
- Department of Paediatric Infectious Diseases, Temple St Children's University Hospital, Ireland
| | - Darach Crimmins
- Department of Neurosurgery, Temple St Children's University Hospital, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
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Pan S, Lin S, Lin J, Chen S, Lin Z. Multiple brain abscesses in an extremely preterm infant and a 12-year follow up: a case report. Ital J Pediatr 2022; 48:99. [PMID: 35710574 PMCID: PMC9205019 DOI: 10.1186/s13052-022-01294-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
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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Affiliation(s)
- Shulin Pan
- Department of Neonatology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Su Lin
- Department of Neonatology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Jing Lin
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, NY, New York, USA
| | - Shangqin Chen
- Department of Neonatology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Zhenlang Lin
- Department of Neonatology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
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Neonatal brain abscess development following fetal scalp electrode placement: a rare complication. Childs Nerv Syst 2022; 38:199-202. [PMID: 33825051 PMCID: PMC8724088 DOI: 10.1007/s00381-021-05150-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/24/2021] [Indexed: 11/08/2022]
Abstract
A fetal scalp electrode (FSE) is a frequently used investigation during labor. However, it is an invasive procedure which can lead to complications. Our patient developed a very large brain abscess after initial superficial infection of the skin site due to an FSE. The patient was admitted to the hospital after an asymmetric growth of the skull was noticed with no further signs of clinical illness. MRI showed a very large brain abscess which was aspirated and treated with antibiotics for 10 weeks. A 2-year follow-up showed only a slight developmental delay in gross motor skills. Only once before a similar case has been described at which the patient developed a brain abscess after superficial infection of the scalp following an FSE. In both cases, the brain abscess was noticed due to an asymmetric growth of the skull without any further signs of clinical illness. A brain abscess has a high mortality and morbidity rate, and early diagnosis is vital for the optimal outcome. We therefore recommend to organize an out-patient clinical follow-up for every infant with a superficial infection of the skin site after placement of an FSE.
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Kanu OO, Ojo O, Esezobor C, Bankole O, Olatosi J, Ogunleye E, Asoegwu C, Eghosa M, Adebayo B, Oladele R, Nwawolo C. Pediatric brain abscess – etiology, management challenges and outcome in Lagos Nigeria. Surg Neurol Int 2021; 12:592. [PMID: 34992909 PMCID: PMC8720435 DOI: 10.25259/sni_605_2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/29/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Brain abscess in children is a neurosurgical emergency with potentially catastrophic outcome despite the advances made in neuroimaging techniques and antibiotic therapy. Symptoms are nonspecific and may vary with the child’s age, location, size, numbers and stage of abscess, and the primary source of infection. Treatment is usually with broad-spectrum antibiotics in combination and surgical evacuation in most cases or antibiotics alone in selected cases with clear-cut indications. This study was to document clinical characteristics, etiological factors, and spectrum of bacteriologic agents responsible for pediatric brain abscess in an African city, the challenges and management outcome over the study period. Methods: This was a retrospective study over an 11-year period involving 89 children who presented with brain abscess. Information of interest was extracted from the medical records of each participant. The results from data analysis were presented in charts and tables. Results: Eighty-nine children aged 0.85–15.7 years (median age of 6.4 years) met the inclusion criteria. The male-to-female ratio was 1.8:1. Headache (80%), fever (78%), and hemiparesis (78%) were the most common symptoms. Brain imaging deployed was CT scan in 56 (63%), MRI in 9 (10%), and transfontanel ultrasound scan in 24 (27%) children. Seventy-one (80%) children had antibiotics with surgical evacuation while 18 (20%) children received only antibiotics. In 19 (27%) children, the culture of the abscess was negative. In 53 (75%) children, Gram-positive aerobic organisms were isolated. A total of 75 patients (84%) had a favorable outcome. Conclusion: Pediatric brain abscess still poses significant public health challenge, especially in resource-limited regions. Successful management of brain abscess requires high index of suspicion for early diagnosis, referral, and intervention.
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Affiliation(s)
- Okezie Obasi Kanu
- Department of Surgery, Division of Neurosurgery, Cardiothoracic Surgical Unit, Lagos State, Nigeria
| | - Omotayo Ojo
- Department of Surgery, Division of Neurosurgery, Cardiothoracic Surgical Unit, Lagos State, Nigeria
| | | | - Olufemi Bankole
- Department of Surgery, Division of Neurosurgery, Cardiothoracic Surgical Unit, Lagos State, Nigeria
| | - John Olatosi
- Department of Anesthesiology, Cardiothoracic Surgical Unit, Lagos State, Nigeria
| | - Ezekiel Ogunleye
- Department of Surgery, Cardiothoracic Surgical Unit, Lagos State, Nigeria
| | - Chinyere Asoegwu
- Department of Surgery, Division of Otorhinolaryngology, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Morgan Eghosa
- Department of Surgery, Neurosurgery Unit, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Bamidele Adebayo
- Department of Surgery, Neurosurgery Unit, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Rita Oladele
- Department of Microbiology, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
| | - Clement Nwawolo
- Department of Surgery, Division of Otorhinolaryngology, College of Medicine, University of Lagos, Lagos State, Nigeria
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Mohamed Ali H, Mustafa M, Suliman S, Elshazali OH, Ali RW, Berggreen E. Inflammatory mediators in saliva and gingival fluid of children with congenital heart defect. Oral Dis 2020; 26:1053-1061. [DOI: 10.1111/odi.13313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/18/2020] [Accepted: 02/20/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Hiba Mohamed Ali
- Department of Clinical Dentistry Faculty of Medicine University of Bergen Bergen Norway
| | - Manal Mustafa
- Oral Health Centre of Expertise in Western Norway Bergen Norway
| | - Salwa Suliman
- Department of Clinical Dentistry Faculty of Medicine University of Bergen Bergen Norway
| | - Osama Hafiz Elshazali
- Faculty of Medicine University of Khartoum Ahmed Gasim Hospital Ministry of Health Khartoum Sudan
| | - Raouf Whahab Ali
- Department of Periodontics University of Science and Technology Khartoum Sudan
| | - Ellen Berggreen
- Oral Health Centre of Expertise in Western Norway Bergen Norway
- Department of Biomedicine Faculty of Medicine and Dentistry University of Bergen Bergen Norway
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Mameli C, Genoni T, Madia C, Doneda C, Penagini F, Zuccotti G. Brain abscess in pediatric age: a review. Childs Nerv Syst 2019; 35:1117-1128. [PMID: 31062139 DOI: 10.1007/s00381-019-04182-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/28/2019] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The purpose of the paper is to examine the current state of the art about epidemiology, diagnosis, and treatment of this infection. METHODS A review of the literature was performed through a PubMed search of original articles, case reports, and reviews using the key words "brain abscess," "cerebral abscess," "brain infection," "intracranial suppuration," "otogenic brain abscess," "otitis complications," and "sinusitis complications." RESULTS Pediatric brain abscess is a rare but serious infection, often involving patients with specific risk factors and burdened by a high risk of morbidity and mortality. Brain abscess incidence and mortality decreased over the years, thanks to improved antibiotic therapy, new neurosurgical techniques, and the wide spread of vaccinations. There are no guidelines for the adequate diagnostic-therapeutic pathway in the management of brain abscesses; therefore, conflicting data emerge from the literature. In the future, multicentric prospective studies should be performed in order to obtain stronger evidences about brain abscesses management. Over the next few years, changes in epidemiology could be observed because of risk factors changes.
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Affiliation(s)
- Chiara Mameli
- Department of Pediatrics, V. Buzzi Childrens' Hospital, University of Milan, Milan, Italy.
| | - Teresa Genoni
- Department of Pediatrics, V. Buzzi Childrens' Hospital, University of Milan, Milan, Italy
| | - Cristina Madia
- Department of Pediatrics, V. Buzzi Childrens' Hospital, University of Milan, Milan, Italy
| | - Chiara Doneda
- Pediatric Radiology and Neuroradiology Unit, Children Hospital V. Buzzi, Milan, Italy
| | - Francesca Penagini
- Department of Pediatrics, V. Buzzi Childrens' Hospital, University of Milan, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Childrens' Hospital, University of Milan, Milan, Italy
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Hall S, Yadu S, Gaastra B, Mathad N, Sparrow O, Waters R, Chakraborty A, Tsitouras V. Paediatric brain abscesses: a single centre experience. Br J Neurosurg 2019; 33:550-554. [DOI: 10.1080/02688697.2019.1587381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Samuel Hall
- Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Shirley Yadu
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Benjamin Gaastra
- Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Nijaguna Mathad
- Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Owen Sparrow
- Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Ryan Waters
- Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Aabir Chakraborty
- Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Vassilios Tsitouras
- Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
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Lajolo C, Favia G, Limongelli L, Tempesta A, Zuppa A, Cordaro M, Vanella I, Giuliani M. Brain abscess of odontogenic origin in children: a systematic review of the literature with emphasis on therapeutic aspects and a new case presentation. ACTA ACUST UNITED AC 2019; 39:67-74. [PMID: 31097823 PMCID: PMC6522858 DOI: 10.14639/0392-100x-2281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/22/2018] [Indexed: 11/29/2022]
Abstract
Brain abscesses (BAs) are rare but life-threatening infections. BAs of an odontogenic origin should always be considered as a possible aetiological factor, especially when other infectious foci are not present. Clinical presentation in children may be ambiguous and pose a difficult differential diagnosis: the identification of causal bacteria can be difficult and odontogenic origin is often a diagnosis of exclusion. The aim of this paper was to systematically review the literature reports with particular emphasis on therapy and propose a diagnostic flowchart for odontogenic brain abscess in children. A systematic literature review was performed on PubMed, Scopus and ISI Web of Science to identify cases of BAs in children and discuss clinical management: only human research articles, published in peer-reviewed English language journals, were included. Among 109 articles, 7 publications were selected for data analysis: clinical data could be extracted for only 8 subjects; different clinical approaches are descripted in the reports, even if therapy should be started as soon as possible to prevent rapid diffusion to the rest of the central nervous system. Due to their rarity and ambiguous clinical presentation in children, BAs of odontogenic origin are difficult to diagnose. A thorough oral-maxillofacial investigation should always be performed to exclude an oral origin.
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Affiliation(s)
- C Lajolo
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS"; School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Favia
- Department of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, "Aldo Moro" University, Bari, Italy
| | - L Limongelli
- Department of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, "Aldo Moro" University, Bari, Italy
| | - A Tempesta
- Department of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, "Aldo Moro" University, Bari, Italy
| | - A Zuppa
- Department of Women's and Children's Health, Division of Paediatrics, "Fondazione Policlinico Universitario A. Gemelli - IRCCS", Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Cordaro
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS"; School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - I Vanella
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS"; School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Giuliani
- Department of Clinical and Experimental Medicine, University of Foggia, Italy
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van der Velden FJS, Battersby A, Pareja-Cebrian L, Ross N, Ball SL, Emonts M. Paediatric focal intracranial suppurative infection: a UK single-centre retrospective cohort study. BMC Pediatr 2019; 19:130. [PMID: 31023283 PMCID: PMC6482535 DOI: 10.1186/s12887-019-1486-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 04/03/2019] [Indexed: 11/10/2022] Open
Abstract
Background Paediatric focal intracranial suppurative infections are uncommon but cause significant mortality and morbidity. There are no uniform guidelines regarding antibiotic treatment. This study reviewed management in a tertiary healthcare centre in the United Kingdom and considers suggestions for empirical treatment. Methods A retrospective, single-centre cohort review of 95 children (< 18 years of age) with focal intracranial suppurative infection admitted between January 2001 and June 2016 in Newcastle upon Tyne, United Kingdom. Microbiological profiles and empirical antibiotic regimens were analysed for coverage, administration and duration of use. Mortality and neurological morbidity were reviewed. Data was analysed using t-tests, Mann-Whitney U tests, independent-samples median tests, and χ2-tests where appropriate. P-values < 0.05 were considered statistically significant. Results Estimated annual incidence was 8.79 per million. Age was bimodally distributed. Predisposing factors were identified in 90.5%, most commonly sinusitis (42.1%) and meningitis (23.2%). Sinusitis was associated with older children (p < 0.001) and meningitis with younger children (p < 0.001). The classic triad was present in 14.0%. 43.8% of 114 isolates were Streptococcus spp., most commonly Streptococcus milleri group organisms. Twelve patients cultured anaerobes. Thirty one empirical antibiotic regimens were used, most often a third-generation cephalosporin plus metronidazole and amoxicillin (32.2%). 90.5% would have sufficient cover with a third generation cephalosporin plus metronidazole. 66.3% converted to oral antibiotics. Median total antibiotic treatment duration was 90 days (interquartile range, 60–115.50 days). Mortality was 3.2, 38.5% had short-term and 24.2% long-term neurological sequelae. Conclusions Paediatric focal intracranial suppurative infection has a higher regional incidence than predicted from national estimates and still causes significant mortality and morbidity. We recommend a third-generation cephalosporin plus metronidazole as first-choice empirical treatment. In infants with negative anaerobic cultures metronidazole may be discontinued.
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Affiliation(s)
- Fabian J S van der Velden
- Paediatric Immunology, Infectious Diseases and Allergy Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Great North Children's Hospital, Newcastle upon Tyne, NE1 4LP, UK.,Erasmus MC, Rotterdam, 3015, CE, The Netherlands
| | - Alexandra Battersby
- Paediatric Immunology, Infectious Diseases and Allergy Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Great North Children's Hospital, Newcastle upon Tyne, NE1 4LP, UK
| | - Lucia Pareja-Cebrian
- Microbiology Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - Nicholas Ross
- Neurosurgery department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - Stephen L Ball
- Otorhinolaryngology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - Marieke Emonts
- Paediatric Immunology, Infectious Diseases and Allergy Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Great North Children's Hospital, Newcastle upon Tyne, NE1 4LP, UK. .,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
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Sahbudak Bal Z, Eraslan C, Bolat E, Avcu G, Kultursay N, Ozkinay F, Kurugol Z, Vardar F. Brain Abscess in Children: A Rare but Serious Infection. Clin Pediatr (Phila) 2018; 57:574-579. [PMID: 28969451 DOI: 10.1177/0009922817733301] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Brain abscess is a rare disease in childhood requiring prompt medical and/or surgical treatment. The objective was to review presentation, management, and outcome of brain abscess in children. We reviewed the clinical and radiological features and outcomes of 18 children (10 females, 8 males), with a median age of 48 months (range 1-182), that presented with brain abscesses and admitted to a tertiary pediatric infectious department between December 2010 and January 2017. One (5.5%) patient underwent craniotomy and 14 (77.7%) had burr hole aspirations. The most common localization was the frontal lobe (33.3%). The survival rate was 94.4%, and long-term neurological sequelae affected 27.7% of the patients. Empiric treatment choices require knowledge of common pathogens and local resistance. The most predominant infections were still upper respiratory infections. Clinicians may treat the children with appropriate choice and duration of antibiotic treatment for upper respiratory tract infections.
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Affiliation(s)
| | - Cenk Eraslan
- 1 Medical School of Ege University, Bornova, Izmir, Turkey
| | - Elif Bolat
- 1 Medical School of Ege University, Bornova, Izmir, Turkey
| | - Gulhadiye Avcu
- 1 Medical School of Ege University, Bornova, Izmir, Turkey
| | | | - Ferda Ozkinay
- 1 Medical School of Ege University, Bornova, Izmir, Turkey
| | - Zafer Kurugol
- 1 Medical School of Ege University, Bornova, Izmir, Turkey
| | - Fadil Vardar
- 1 Medical School of Ege University, Bornova, Izmir, Turkey
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