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KMID : 0605820080150010029
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Korean Journal of Pediatric Infectious Diseases
2008 Volume.15 No. 1 p.29 ~ p.34
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Clinical Features of Brain Abscesses in Neonates and Children : A Single Center Experience from 1997 to 2006
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Lee Teak-Jin
Kim Ki-Hwan
Kim Dong-Soo
Chun Jin-Kyoung
Kim Khi-Joo
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Abstract
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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.
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KEYWORD
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Brain Abscess, Neurosurgery, Infant, Children
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