Neonatal Brain Abscess: Case Report of 12 Cases and Literature Review

Abstract

Objective: To investigate the etiological characteristics, clinical manifestations, and early identification methods of neonatal brain abscess. Methods: The baseline characteristics, clinical manifestations, and laboratory results of 12 neonatal brain abscess cases were retrospectively analyzed. Results: The clinical manifestations were fever, convulsion, and lethargy. A small number of them had respiratory and circulatory failure. The diagnosis made was based on imaging examination. All 12 cases were confirmed by cranial enhanced computed tomography (CT) or magnetic resonance imaging (MRI). Blood cultures of 9 cases were positive, with Escherichia coli in 6 cases, ?-hemolytic Streptococcus in 1 case, methicillin-resistant Staphylococcus aureus in 1 case, and Enterococcus faecium in 1 case. However, only 3 of them had positive cerebrospinal fluid (CSF) cultures. All the 12 neonates were treated with antibiotic therapy upon admission, with only 3 cases treated with surgery. Among them, 4 recovered and were discharged, while the remaining 8 discontinued their therapy. Conclusion: Escherichia coli is the most common pathogen of neonatal brain abscess in our study. The clinical manifestations of neonatal brain abscess are atypical, and the prognosis is poor. Respiratory and circulatory failure in children with intracranial infection may indicate the presence of brain abscess. For children with suspected brain abscess, cranial enhanced CT or MRI should be performed as soon as possible to make an early diagnosis. The prevention of brain abscess should be prioritized; neonates with sepsis or meningitis should receive prompt and strong antibiotic therapy in an effort to prevent the development of brain abscess.