Ultrasound-guided brain abscess aspiration in neonates

Abstract

Four cases of brain abscess in neonates are described, diagnosed by ultrasonography and CT. All abscesses were confirmed surgically. One patient was operated on 5 weeks after diagnosis because of initial parental refusal. The etiology in all cases was meningitis superimposed on an hypoxic-ischemic insult. Two cases had a single abscess while the other two had multiple lesions. All cases were operated on with intraoperative ultrasound examination through the fontanelle. The case with delayed aspiration showed complete evolution from localized cerebritis to complete capsule formation with mass effect. One abscess was sterile, and in the others grew Klebsiella pneumoniae and Enterobacter aerogenes. The microorganism initially isolated from the lumbar CSF was also found in the abscess. Even after sterilization of the lumbar CSF, all abscesses were still present. Ultrasound examination and CT are compared.

Converting Emergency Pilonidal Abscess Into an Elective Procedure

“…Traditional approaches to the management of acute pilonidal abscess revolve around various techniques of drainage, such as incision and drainage, deroofing, with or without curettage, excision, and marsupialization, all of which are associated with slow wound healing, increased aftercare requirements, significant loss of working time, and a variable recurrence rate. [1][2][3][4][5][6] Aspiration, with or without radiology guidance, and empirical antibiotics are widely described in the management of many organ system abscesses, as in the liver, brain, prostate, and ovaries [7][8][9][10][11][12] ; and, in abscesses such as those of the breast, aspiration and empirical antibiotics have become the first line of management, [13][14][15][16] with a high success rate (97% in puerperal vs 81% in nonpuerperal breast abscess). 13 Here, we present the safety and efficacy of aspiration and empirical antibiotic treatment of acute pilonidal abscess in which a temporizing intervention allows subsequent definitive treatment with low morbidity.…”

Klebsiella pneumoniae Brain Abscess in Neonates: A Report of 2 Cases

“…1 Klebsiella pneumoniae has been very rarely implicated as a cause of neonatal brain abscess. 2 We report the presentation of 2 neonates who developed brain abscesses following Klebsiella pneumoniae sepsis.…”

An Unusual Case of Neonatal Brain Abscess Following Klebsiella pneumoniae Septicemia

“…In one of the largest series of 30 neonates with brain abscesses in a tertiary center, no case was attributed to Klebsiella [2]. Theophilo et al [4] reported one case of Klebsiella abscess following meningitis in a term neonate who had undergone resuscitative intervention at birth.The present case appears especially rare because, to our knowledge, it is the first report of neonatal brain abscess following Klebsiella sepsis in a full term AFD neonate without any antecedent risk factor.…”

“…Citrobacter koseri (formerly known as Citrobacter diversus) and Proteus species are the most commonly reported organisms causing neonatal brain abscess in the majority of the published reports to date [1][2][3].There is a paucity of reports implicating Klebsiella pneumoniae as the causative organism of neonatal cerebral abscess [4]. In this report, we present a case of large solitary brain abscess in a term appropriate for date (AFD) neonate where K. pneumoniae was isolated from blood and aspirate taken from the abscess cavity in the brain.…”