Brain abscess; Children in Southern province of Saudi Arabia Kingdom

ABSTRACT

To evaluate the clinical presentation diagnosis, sources of infection, surgical management outcome and microorganisms involved in the brain abscess in our locality. This study was carried out in the department of Neurosurgery, Aseer Central Hospital Abha, Southern Province, KSA from 1426 H -1433 H [2005-2012 AD]. A total of 30 children aged less than 15 years were reviewed. There were 15 males and 15 females. The mean age of presentation was 5.6+/-4.4 years. patients presented with fever, vomiting, headache and seizures. The predisposing conditions found were cyanotic congenital heart disease in 11 [37%] of children, meningitis in 6 [20%], septicemia in 7 [23%] and no underlying cause was found in 5 [17%] children. The most common microbe in children with cyanotic congenital heart disease was of the Streptococcus milleri group [52%]. All abscesses were large, more than 2 cm in diameter and were aspirated surgically. Excision was performed in 6 children. Five children expired, one due to a intracranial bleeding and the others due to severe cerebral edema and tentorial herniation. Complications were seen in 20 children and 16 had sequelae, hemiparesis in 11 and seizure disorder in 5. It is concluded from the study that delayed surgical drainage has high morbidity and mortality. Diagnosis with CT scan, appropriate antibiotic therapy and complete aspiration of abscess reduced the mortality and neurological deficits from brain abscess