Childhood pyogenic brain abscess: Clinical presentations In Thai reports

Abstract

Objective: The childhood pyogenic brain abscess is an important brain infection. This condition is uncommon and interesting. Materials and Methods: Here, the author performed a retrospective review of Thai reports on childhood pyogenic brain abscess. Results: The literature review and summarization on the previously reported 235 cases of childhood pyogenic brain abscesses was done. Conclusion: Fever, headache, vomiting, alteration of consciousness, and focal neurologic deficit are common. Several kinds of pathogen (Streptococci, Proteus, and Staphylococcus aureus) are detected.

Keywords: Abscess, childhood, pyogenic

How to cite this article:
Wiwanitkit S, Wiwanitkit V. Childhood pyogenic brain abscess: Clinical presentations In Thai reports. Ann Trop Med Public Health 2012;5:563-4

 

How to cite this URL:
Wiwanitkit S, Wiwanitkit V. Childhood pyogenic brain abscess: Clinical presentations In Thai reports. Ann Trop Med Public Health [serial online] 2012 [cited 2013 Aug 20];5:563-4. Available from: https://www.atmph.org/text.asp?2012/5/6/563/109265

 

Introduction

The childhood pyogenic brain abscess is an important brain infection. This condition is uncommon and interesting. There are some reports on this topic and it is usually a small sample size report. [1],[2],[3] This condition required good diagnosis and prompt treatment. Therapy of choice can be the administration of adequate antibiotics or computed tomography (CT)-guided needle aspirations. [4] Of interest, there are discrepancies between the data of the infected cases among different reports. [1],[2],[3] Hence, the study on the characteristics and presentations of childhood brain abscess in different settings is very useful. Here, the author performed a retrospective review of Thai reports on childhood pyogenic brain abscess.

Materials and Methods

This work is a retrospective descriptive study. The aim is to summarize on Thai reports on childhood pyogenic brain abscess. The author performed a literature review using search engines, PubMed and ThaiIndexMedicus. The reports without complete data were excluded for further assessment. For each report, the patient characteristics and clinical data were collected. Summative analysis using descriptive statistical analysis was done.

Results

Based on this work, there are four reports [5],[6],[7],[8] covering 235 cases of childhood pyogenic brain abscesses. The age range of the patients is between 0.25 year and 14 years (age average equal to 7.98 + 3.48 years). There are 141 males and 94 females (ratio = 1.5:1). There are 46 death cases giving fatality rate equal to 19.6%. Focusing on the underlying disease, congenital heart disease and chronic otitis can be seen in 52.5% and 11.5%. There are several clinical presentations including fever (67.5%), nausea (71.5%) and vomiting, headache (80.5%), alteration of consciousness (56.5%), and localized neurological disorder (72.5%). The brain lesion can be either single (72.5%) and multiple (27.5%). For the case with single brain lesion, the lesion can be seen at any lobe of cerebrum (parietal 35.5%, temporal 28.5%, occipital 5%, and frontal 3.5%). Focusing on the pathogen, a single organism was isolated in 55.5%.

Discussion

According to this work, there are many significant observations among the Thai children that are different from previous reports from other settings. [1],[2],[3] The high rate of underlying congenital heart disease can be, hereby, observed. In addition, there are some cases of below -1-year patients. In addition, there is no report on extracerebral brain abscess. However, the similar fatality rate to the previous reports on pyogenic brain abscess can be seen. [1],[2],[3] Also, the fatality rate among the pediatric population is considered high comparing to the reported rate among overall population (both pediatric and adult populations). [9] This implies the importance of this condition in any settings.

The classical signs and symptoms of brain abscess as seen in any population can be seen. [9] Fever, headache, vomiting, alteration of consciousness, and focal neurologic deficit are common. Several kinds of pathogen (Streptococci, Proteus, and Staphylococcus aureus) are detected. In addition, very rare pathogen, Citrobacter freundii, is detected in two cases. Focusing on treatment, it can be seen that the standard treatment is acceptable.

References

 

1. Jamjoom A. Childhood brain abscess in Saudi Arabia. Ann Trop Paediatr 1997;17:95-9.
2. Ubeda Sansano MI, Estañ Capell M, Escribano Montaner A, Martínez Costa C, Hernández Marco R. Cerebral brain abscess in childhood: A report of 5 cases. An Esp Pediatr 1996;45:177-80.
3. Domingo Z, Peter JC. Brain abscess in childhood. A 25-year experience. S Afr Med J 1994;84:13-5.
4. Aebi C, Kaufmann F, Schaad UB. Brain abscess in childhood-long-term experiences. Eur J Pediatr 1991;150:282-6.
5. Ratanasiri B. Ten year review of brain abscess in Children’s Hospital Bangkok, Thailand. J Med Assoc Thai 1995;78:37-41.
6. Raksadawan N, Balankura K, Charoenchonvanich S. Brain abscesses in children. Siriraj Hosp Gaz 1995;47:9-19.
7. Charoenchonvanich S. Retrospective study of brain abscess in children in Siriraj Hospital. Thailand J Pediatr 1994;33:s6.
8. Auvichayapat N, Auvichayapat P, Aungwarawong S. Brain abscess in infants and children: A retrospective study of 107 patients in north east Thailand. J Med Assoc Thai 2007;90:1601-7.
9. Wiwanitkit S, Wiwanitkit V. Pyogenic brain abscess in Thailand. North Am J Med Sci 2012;4:245-8.

DOI: 10.4103/1755-6783.109265

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