Brain Abscesses Complicating Staphylococcus aureus Sepsis in a Premature Infant

Abstract

Brain abscess is a rare complication of staphylococcal bacteremia in infants. Here we present a case of a premature infant who developed multiple brain abscesses 12 weeks following an episode of inadequately treated Staphylococcus aureus sepsis. The abscess developed in the absence of trauma, prior surgery, cyanotic heart disease, or immune defect. The initial staphylococcal isolate exhibited identical pulsed-field gel electrophoresis pattern with that of the isolate cultured from abscess aspirate. The infant was successfully treated by surgical drainage and administration of antibiotics for 12 weeks, initially teicoplanin and meropenem followed by trimethoprim/sulfamethoxazole, without neurological or developmental sequelae. Staphylococcal bacteremia in neonates should be vigorously treated to prevent life-threatening complications.

Spinal Infections: An Update

“…Bacteria can reach the spine and infect the spinal column via the following three routes: (1) hematogenous spread from a remote site, (2) direct external inoculation after trauma (injury or surgery), and (3) dissemination from a contiguous tissue [1]. Hematogenous spread is the most common route for vertebral osteomyelitis in children and adults [22][23][24][25][26][27][28][29]. Generally, any condition that results in circulation of microorganisms into the blood stream (bacteremia) such as surgery or more benign events such as tooth brushing or venipuncture, can lead to hematogenous spondylodiscitis.…”

Penetration of the blood–brain barrier by Staphylococcus aureus: contribution of membrane-anchored lipoteichoic acid

“…Brain abscesses are a complication that may arise following surgery, head injury or from inadequately treated S. aureus sepsis or meningitis [11]. Although meningitis is considered a rare complication of S. aureus infection, there are an increasing number of clinical reports detailing meningitis resulting from S. aureus infection of an unknown source [12, 13]. In these cases, hematogenous spread of bacteria from a primary site of infection implies that S. aureus has the ability to cross the BBB to penetrate the CNS.…”

Successful Treatment with Ultrasound-Guided Aspiration of Intractable Methicillin-Resistant <i>Staphylococcus aureus</i> Brain Abscess in an Extremely Low Birth Weight Infant

“…Needle aspiration is necessary not only for identification of the organism, but also for reduction of the bacterial load in the abscess cavity. Although there have been no randomized controlled studies to demonstrate the optimal duration of medical therapy of brain abscesses in infants, clinical experience has shown that prolonged administration of antibiotics for 8 weeks along with surgical drainage is required for a good outcome [1]. Mamelak et al [7] recommended that aggressive surgical drainage be combined with 6-8 weeks of intravenous antibiotics when the abscess is >2.5 cm in diameter and the lesion is multiloculated, regardless of the causative organism.…”

“…Methicillin-resistant Staphyloccocus aureus (MRSA) has been very rarely implicated as a cause of cerebral abscess in neonates in the absence of any predisposing factors [1,2]. Since neonate cranial sutures have not yet fused, a brain abscess associated with delayed symptom onset may be identified later with routine brain sonography [3].…”