Childhood brain abscesses are a rare and potentially life-threatening condition requiring urgent diagnosis and treatment. This retrospective study analyzed the clinical and radiologic findings of 24 (7 girl, 17 boys) cases with brain abscess. Mean age was 92.98 ± 68.04 months. The most common presenting symptoms were nausea-vomiting (45.8%) and headache (41.7%). Brain abscess was most commonly located in the frontal region. Diffusion restriction was determined in 78.4% of lesions. The mean apparent diffusion coefficient value in these lesions was 0.511 ± 0.23 × 10–3 mm2/s. Cultures were sterile in 40% of cases. Antimicrobial therapy was given to only 16.7% of cases. Predisposing factors were identified in 91.6% of cases (congenital heart disease in 20.8% and immunosuppression in 20.8%). Mortality level was 12.5%. In conclusion, immunocompromised states, and congenital heart disease have become an important predisposing factor for brain abscesses. Effective and prompt management should ensure better outcome in childhood.
FrazierJLAhnESJalloGI. Management of brain abscesses in children. Neurosurg Focus. 2008;24:E8.
2.
HakanTCeranNErdemI. Bacterial brain abscesses: an evaluation of 96 cases. J Infect. 2006;52:359–366.
3.
YogevRBar-MeirM. Management of brain abscesses in children. Pediatr Infect Dis J. 2004;23:157–159.
4.
OzsürekciYKaraACengizAB. Brain abscess in childhood: a 28-year experience. Turk J Pediatr. 2012;54:144–149.
5.
Shachor-MeyouhasYBar-JosephGGuilburdJN. Brain abscess in children—epidemiology, predisposing factors and management in the modern medicine era. Acta Paediatr. 2010;99:1163–1167.
6.
Saez-LlorensX. Brain abscess in children. Semin Pediatr Infect Dis. 2003;14:108–114.
7.
AuvichayapatNAuvichayapatPAungwarawongS. Brain abscess in infants and children: a retrospective study of 107 patients in Northeast Thailand. J Med Assoc Thai. 2007;90:1601–1607.
8.
TsouTPLeePILuCY. Microbiology and epidemiology of brain abscess and subdural empyema in a medical center: a 10-year experience. J Microbiol Immunol Infect. 2009;42:405–412.
9.
Gelabert-GonzálezMSerramito-GarcíaRGarcía-AllutACutrín-PrietoJ. Management of brain abscess in children. J Paediatr Child Health. 2008;44:731–735.
10.
SarmastAHShowkatHIBhatAR. Analysis and management of brain abscess; a ten year hospital based study. Turk Neurosurg. 2012;22:682–689.
11.
NathooNNadviSSNarotamPKvan DellenJR. Brain abscess: management and outcome analysis of a computed tomography era experience with 973 patients. World Neurosurg. 2011;75:716–726.
12.
KaoKLWuKGChenCJ. Brain abscesses in children: analysis of 20 cases presenting at a medical center. J Microbiol Immunol Infect. 2008;41:403–407.
13.
KrajewskiRStelmasiakZ. Brain abscess in infants. Childs Nerv Syst. 1992;8:279–280.
14.
GoodkinHPHarperMBPomeroySL. Intracerebral abscess in children: historical trends at Children’s Hospital Boston. Pediatrics. 2004;113:1765–1770.
15.
FelsensteinSWilliamsBShingadiaD. Clinical and microbiologic features guiding treatment recommendations for brain abscesses in children. Pediatr Infect Dis J. 2013;32:129–135.
16.
WongTTLeeLSWangHS. Brain abscesses in children—a cooperative study of 83 cases. Childs Nerv Syst. 1989;5:19–24.
17.
TekkökIHErbengiA. Management of brain abscess in children: report of 130 cases over a period of 21 years. Childs Nerv Syst. 1992;8:411–416.
18.
HirschJFRouxFXSainte-RoseC. Brain abscess in childhood. A study of 34 cases treated by puncture and antibiotics. Childs Brain. 1983;10:251–65.
19.
LandrielFAjlerPHemS. Supratentorial and infratentorial brain abscesses: surgical treatment, complications and outcomes—a 10-year single-center study. Acta Neurochir (Wien). 2012;154:903–911.
20.
PatirogluTUnalEKarakukcuM. Multiple fungal brain abscesses in a child with acute lymphoblastic leukemia. Mycopathologia. 2012;174:505–509.
21.
PatirogluTUnalEYikilmazA. Atypical presentation of chronic granulomatous disease in an adolescent boy with frontal lobe located Aspergillus abscess mimicking intracranial tumor. Childs Nerv Syst. 2010;26:149–154.
22.
ErdoganCHakyemezBYildirimNParlakM. Brain abscess and cystic brain tumor: discrimination with dynamic susceptibility contrast perfusion-weighted MRI. J Comput Assist Tomogr. 2005;29:663–667.
23.
ChangSCLaiPHChenWL. Diffusion-weighted MRI features of brain abscess and cystic or necrotic brain tumors: comparison with conventional MRI. Clin Imaging. 2002;26:227–236.
24.
LaiPHHsuSSDingSW. Proton magnetic resonance spectroscopy and diffusion-weighted imaging in intracranial cystic mass lesions. Surg Neurol. 2007;68:25–36.
25.
FanningNFLaffanEEShroffMM. Serial diffusion-weighted MRI correlates with clinical course and treatment response in children with intracranial pus collections. Pediatr Radiol. 2006;36:26–37.
26.
EbisuTTanakaCUmedaM. Discrimination of brain abscess from necrotic or cystic tumors by diffusion-weighted echo planar imaging. Magn Reson Imaging. 1996;14:1113–1116.
27.
DesprechinsBStadnikTKoertsG. Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscess. AJNR Am J Neuroradiol. 1999;20:1252–1257.
28.
NoguchiKWatanabeNNagayoshiT. Role of diffusion-weighted echo-planar MRI in distinguishing between abscess and tumor: a preliminary report. Neuroradiology. 1999;41:171–174.
29.
SundaramVAgrawalSChachamS. Klebsiella pneumoniae brain abscess in neonates: a report of 2 cases. J Child Neurol. 2010;25:379–382.
30.
KrabbeKGideonUWagnP. MR diffusion imaging of intracranial tumors. Neuroradiology. 1997;39:483–489.
31.
MishraAMGuptaRKJaggiRS. Role of diffusion weighted imaging and in vivo proton magnetic resonance spectroscopy in the differential diagnosis of ring enhancing intracranial cystic mass lesions. J Comput Assit Tomogr. 2004;28:540–547.
32.
PhanHLehmanD. Cerebral abscess complicating Proteus mirabilis meningitis in a newborn infant. J Child Neurol. 2012;27:405–407.
33.
LumbiganonPChaikitpinyoA. Antibiotics for brain abscesses in people with cyanotic congenital heart disease. Cochrane Database Syst Rev. 2013;3:CD004469.
34.
CiureaAVStoicaFVasilescuGNuteanuL. Neurosurgical management of brain abscesses in children. Childs Nerv Syst. 1999;15:309–317.
