Brain abscess in infants and children: a retrospective study of 107 patients in northeast Thailand.

ABSTRACT

OBJECTIVE: To review the clinical manifestation, predisposing factor location of abscess, causative organism, treatment, and outcome of brain abscess. STUDY DESIGN: Descriptive retrospective study. SETTING: Srinagarind Hospital, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen. MATERIAL AND METHOD: One hundred and seven infants and children with brain abscess that admitted between 1985 and 2005 are analyzed retrospectively. RESULTS: The mean age was 8.4 years. The male-to-female ratio was 1.31. The most common predisposing factor was congenital heart disease. The most common organisms in congenital heart disease, chronic otitis media, and unknown source were Streptococci, Proteus, and Staphylococcus aureus respectively. Two very rare cases of Citrobacter freundii brain abscesses were reported. Only 9.4% had classic triad signs and symptoms of brain abscess. The overall mortality rate was 10.7%. CONCLUSION: The clinical features and outcomes of treatments of 107 infants and children with brain abscesses were reviewed. Congenital heart diseases and chronic otitis media were the most common predisposing factors. The common signs and symptoms were fever, headache, vomiting, alteration of consciousness, and focal neurologic deficit. The overall mortality rate was 10.7%.