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| Retrospective analysis of clinical features of 36 children with brain abscess |
| XU Juanyu1 DENG Yaxian1 GONG Jian2 CHEN Ning2 CHEN Na1 |
1.Department of Pediatrics, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2.Department of Pediatric Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
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Abstract Objective To analyze the etiology, clinical features, imaging features, and treatment and prognosis of brain abscess in children, and to further understand brain abscess. Methods A total of 36 hospitalized children with definite diagnosis of pediatric brain abscess admitted to the Department of Pediatrics and Neurosurgery of Beijing Tiantan Hospital, Capital Medical University from January 2014 to December 2021 were selected. The distribution at different ages, clinical manifestations, etiological examination, imaging examination, peripheral blood/pus culture, parasitic infection, etiological analysis, and treatment and prognosis of brain abscess in children were observed. Results The age＜11 years of onset of pediatric brain abscess was 24 cases. The most common neurological manifestations of pediatric brain abscess were headache, followed by fever and vomiting. The most commonly affected site was the frontotemporal lobe, which was dominated by single abscess. In peripheral blood culture examination, only one case was positive; among the 28 cases of pus culture, 12 cases were positive, mainly streptococcus and staphylococcus. No parasitic infection was found in the 36 children. The etiology was clear in 23 of the 36 cases, otitis media was the main cause, followed by brain trauma and congenital heart disease. A total of 28 cases underwent surgical treatment and eight cases received conservative medical treatment. Thirty-one of the 36 cases were cured and discharged from hospital, two cases had sequelae, and three cases gave up treatment. By December 2021, no abscess recurrence was observed and three patients died. Conclusion Early childhood is the peak of pediatric brain abscess, headache is the most common clinical manifestations. Otitis media, heart disease, and brain trauma are the main causes of brain abscess, frontotemporal lobe abscess is more common, the positive rate of pus culture is higher than that of blood culture, streptococcus mostly.
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