Brain abscess in infants and children

Sáez-Llorens, Xavier; Umaña, Maria A.; Odio, Carla; McCracken, George H.; Nelson, John D.

doi:10.1097/00006454-198907000-00009

Cited by 80 publications

(91 citation statements)

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“…Neonatal meningitis when caused by Citrobacter diversus or Proteus mirabilis is complicated by abscess formation in 40 to 70% of patients 1,2 . Approximately 15 to 20% of Gram-negative bacterial meningitis are complicated by abscess.…”

Section: Discussionmentioning

confidence: 99%

Brain abscess by citrobacter diversus in infancy: case report

Feferbaum

Diniz

Valente

et al. 2000

Arq. Neuro-Psiquiatr.

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-Citrobacter diversus is closely related to brain abscess in newborn infants. We describe a case of brain abscess by this bacteria in a newborn infant and his clinical and cranial computed tomographic evaluation until the fourth month of life and discuss therapeutic management of this patient.KEY WORDS: infancy, brain abscess, Citrobacter diversus.Abscesso cerebral por Citrobacter diversus na infância: relato de caso RESUMO -Citrobacter diversus é a bactéria mais associada a abscessos cerebrais durante o período neonatal. Descrevemos um caso de abscesso cerebral por esta bactéria em um recém-nascido e sua evolução clínica e tomográfica até o quarto mês de vida. São discutidos aspectos diagnósticos e terapêuticos desta grave infecção do recém-nascido. PALAVRAS-CHAVE: infância, abscesso cerebral, Citrobacter diversus.Although not common in the neonatal period, brain abscesses have a high mortality rate and appear as complication of neonatal meningitis in 1.3 to 4.0% of patients. In neonates the progression of the disease may be insidious, with clinical manifestations resembling other neurological pathologies of the neonatal period, such as congenital hydrocephalus. The high frequency and death rates of brain abscesses caused by Citrobacter diversus makes clear the need for an early diagnosis and treatment.In this article we discuss the case of an infant with a brain abscess by Citrobacter diversus, his outcome, and a review of the literature on this pathology. CASEGRT, 47 days old, male, admitted in the neonatal intensive care unit (NICU) in 07/27/97. Obstetrical history: full term infant, uncomplicated gestation, delivered by elective cesarean section with unruptured membranes, Apgar scores of 9 (1 st minute) and 9 (5 th minute). Personal history: birth weight 3,420 g, height 48 cm, head circumference (HC) 34 cm, thoracic circumference 33 cm; discharged from the maternity hospital after 3 days.Admitted in a pediatric clinic at the age of 46 days, with a one day history of poor feeding, nausea, irritability, lethargy and fever (37.7 o C), and signs of respiratory distress, raised anterior fontanel and enlarged HC (42.3 cm). A complete blood count was done with hemoglobin level 7,0 g/dl, hematocrit 21%, white blood cell count (WBC) 14,900/mm 3 with 80% neutrophils (9% band cells) in the differential. A spinal tap was performed

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Section: Discussionmentioning

confidence: 99%

Brain abscess by citrobacter diversus in infancy: case report

Feferbaum

Diniz

Valente

et al. 2000

Arq. Neuro-Psiquiatr.

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“…Superficial and encapsulated abscesses were excised. Abscesses located in deeper critical regions (e.g., brain stem, cerebellum, or diencephalic structures adjacent to the ventricle) should be stereotactically drained or a biopsy taken for culture and tissue diagnosis 13,22,25) . Staphylococcus aureus and enterobacteriaceae are commonly isolated from brain abscesses following head injury and postoperative infections 7,19,24) .…”

Section: Discussionmentioning

confidence: 99%

Rapid Development of Brain Abscess Caused by Streptococcus Pyogenes Following Penetrating Skull Injury via the Ethmoidal Sinus and Lamina Cribrosa

Gülşen

Gerilmez

Serhat

et al. 2010

J Korean Neurosurg Soc

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Objective : Streptococcus pyogenes is a beta-hemolytic bacterium that belongs to Lancefield serogroup A, also known as group A streptococci (GAS). There have been five reported case in terms of PubMed-based search but no reported case of brain abscess caused by Streptococcus pyogenes as a result of penetrating skull injury. We present a patient who suffered from penetrating skull injury that resulted in a brain abscess caused by Streptococcus pyogenes. Methods : The patient was a 12-year-old boy who fell down from his bicycle while cycling and ran into a tree. A wooden stick penetrated his skin below the right lower eyelid and advanced to the cranium. He lost consciousness on the fifth day of the incident and his body temperature was measured as 40˚C. While being admitted to our hospital, a cranial computed tomography revealed a frontal cystic mass with a perilesional hypodense zone of edema. There was no capsule formation around the lesion after intravenous contrast injection. Paranasal CT showed a bone defect located between the ethmoidal sinus and lamina cribrosa. Results : Bifrontal craniotomy was performed. The abscess located at the left frontal lobe was drained and the bone defect was repaired. Conclusion : Any penetrating lesion showing a connection between the lamina cribrosa and ethmoidal sinus may result in brain abscess caused by Streptococcus pyogenes. These patients should be treated urgently to repair the defect and drain the abscess with appropriate antibiotic therapy started due to the fulminant course of the brain abscess caused by this microorganism. KEY WORDS :Brain abscess˙ Skull base repairing˙ Penetrating head injury˙ Streptococcus pyogenes˙ Surgical evacuation.

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“…Hematogenous dissemination from a distant focus of infection usually results in multiple brain abscesses with one type of bacteria, whereas contagious infection cause single polymicrobial abscess (4) . Cyanotic congenital heart disease (CCHD) is an important predisposing factor for hematogenous spread of bacteria, and accounts for 6-50% of the cases (5) . However our patient was healthy, had not any contagious infection or predisposing factors, and had one abscess caused by two bacteria; Aggregatibacter aphrophilus and Streptococcus intermedius.…”

Section: Dıscussıonmentioning

confidence: 99%